The Burden of Depressive and Bipolar Disorders in Celiac Disease

Mauro Giovanni Carta1, *, Alessandra Conti1, Federica Lecca1, Federica Sancassiani1, Giulia Cossu1, Rossana Carruxi2, Alessandro Boccone2, Michela Cadoni1, Anna Pisanu1, Maria Francesca Moro1, Luigi Demelia2
1 Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy
2 Department of Medicine “Mario Aresu”, University of Cagliari, Italy

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© Carta et al.; Licensee Bentham Open.

open-access license: This is an open access articles licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided that the work is properly cited.

* Address correspondence to this author at the Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy; Tel: +39 0706093498; E-mail:


Introduction: Aims: to measure the association between Celiac Disease (CD) and affective disorders, particularly Bipolar Disorder (BD), since it has not been studied yet, and to measure how much the quality of life (QoL) of a person with CD is affected by comorbidity with these disorders. Methods: Design: Case-control study. Cases: 60 consecutive patients with CD. Controls: 240 subjects without CD, randomly selected after sex- and age-matching from a database of an epidemiological study. Psychiatric diagnoses according to DSM-IV carried out by physicians using structured interview tools (ANTAS-SCID). QoL was measured by means of SF-12. Results: The lifetime prevalence of Major Depressive Disorder (MDD) was higher in CD than in controls (30.0% vs 8.3%, P<0.0001) as well as Panic Disorder (PD) (18.3% vs 5.4%, P<0.001) and BD (4.3% vs 0.4%, P<0.005). Patients with CD show a lower mean score than controls on SF12 (35.8±5.7 vs. 38.2±6.4; p=0.010), but those without comorbidity with MDD, PD and BD do not. The attributable burden of CD in worsening QoL - when comorbid with these disorders - was found comparable to that of serious chronic diseases like Wilson’s Disease, and lower than Multiple Sclerosis only. Conclusion:MDD, PD and BD are strictly associated with CD. The comorbidity with these disorders is the key determinant of impaired quality of life in CD. Thus a preventive action on mood and anxiety disorders in patients suffering from CD is required. Moreover a screening for CD in people with affective disorders and showing key symptoms or family history of CD is recommended.

Keywords: Attributable burden, bipolar disorder, case control study, celiac disease, depressive disorder, quality of life. .