Anxiety Symptoms in Adult Celiac Patients and the Effect of a Gluten-Free Diet: An Iranian Nationwide Study

Abstract

Introduction: Psychiatric disorders, especially anxiety, are considered extraintestinal manifestations of celiac disease (CD).

Objective: This study aims to evaluate the level of anxiety in treated patients with CD in Iran.

Methods: A total of 283 CD patients (190 female, 93 male) were enrolled in a study during 2016-2018 from 9 centers in Iran. The Zung Self-Rating Anxiety Scale questionnaire was completed. The anxiety index was calculated. Also, demographic data and the duration of treatment with a gluten-free diet (GFD) were recorded. Data were analyzed by SPSS version 20.

Results: Anxiety symptoms were reported in 67.8% of patients. Female patients had a higher anxiety index than male patients. Duration of treatment with a GFD did not influence the anxiety index (17.3% were on a GFD for <1 year, 33.6% for 1-2 years, and 49.1% had GFD for >2 years; p = 0.86).

Conclusions: These results suggest that anxiety symptoms are common among patients, especially females, with CD in Iran and GFD duration has no effect on their improvement.

Keywords: Anxiety; Celiac disease; Gluten-free diet; Iran; Zung Self-Rating Anxiety Scale.