Celiac Disease Patients do not Experience More Depression

A new study found that those with celiac disease are no longer more likely to become depressed or experience sleep difficulty as compared to the whole population. This new study was based on a national health survey. The study also showed that people who observe gluten-free diet and have not been diagnosed with the disease had fewer chances of being depressed. The authors of the study wrote that undiagnosed and diagnosed participants had same chances of depression as compared to controls.

Researchers from Mayo Clinic and Colombia University analyzed data on over 22,000 participants in a survey conducted in 2009-2014. The study collected laboratory data and physical examination data from over 5,000 participants each year. Researchers found 76 incidences of celiac disease. 21 of the 76 cases were diagnosed, and 56 were not diagnosed. Those who were not diagnosed tested positive for celiac disease. 213 didn’t have the disease, and they reported that they followed a gluten-free diet and they decided to do so.

The existence of sleep disorders and depression was determined by what the participants reported after answering some questionnaires. One survey asked about prescription drugs in treating depression.

Depression is not inherent

The study found that 8.1% of the participants who were diagnosed with the disease had depression. Also, 8.2% of the controls reported having depression. 2.3% of those who were not diagnosed but tested positive for the disease had depression. However, the numbers were different when researchers made changes in some variables such as sex and age. They reported that the low chances of being depressed in those who were not diagnosed with the celiac disease weren't statistically significant anymore. The authors also wrote that depression is not a prominent feature of untreated and undiagnosed celiac disease.

The study suggested that depression might not be inherent functional change accompanying celiac disease whether someone followed a gluten-free diet or not. The authors of the survey said that depression might be seen among celiac disease patients as they struggle with the chronic nature of this illness, symptoms, related medical conditions and burden of following a gluten-free diet.

Previous studies showed that there was a link between increased depression and celiac disease. Others refuted the findings. Some link adoption of gluten-free diet and diagnosis to depression. Others reported depression even after they are treated for celiac disease. Usually, people consider depression as one of the symptoms of the illness and some people report feeling depressed before diagnosis with improvement on a gluten-free diet. Others indicated that they got depressed after diagnosis mainly due to the limitation of the diet they could eat and social isolation. The study took note of the inconsistencies, and its authors stated that use of large population was their strength. They said that they used an unbiased sampling technique to come up with their findings. However, they said that a small number of people with celiac disease in the sample might have caused underestimation of the prevalence of depression.

Benjamin Lebwohl, who was one of the authors, said that a larger study might show that there was a reduced risk of depression. Lebwohl stated that no trend showed increased risk.

Why the lower risk

People without diagnosis and on a gluten-free diet has 2.9% rate of depression. This rate is lower than the controls and celiac disease patients. The study reported that it was possible that following a gluten-free diet could have led to a low risk of depression. The study also takes not that that was unlikely since those diagnosed followed a gluten-free diet and didn’t report small chances of depression.

Lebwohl said that the study didn’t clarify why those without celiac disease and followed a gluten-free diet had a lower risk of depression.

He said that there could be a protective effect of the gluten-free food about depression. He also said that for those with celiac disease, the burden of following the diet counterbalances it. It should be noted that participants with celiac disease didn’t have a higher rate of sleep disturbances and depression as compared to the general population. In Lebwohl’s opinion, he said that this doesn’t diminish the difficulty involved in the diet and living with the disease. It, however, underscores that depression is also found in the general public.

Whether someone has celiac disease or not, depression is treatable and serious. This study was the first to concentrate on sleep problems among those with celiac disease in the U.S. in the study; there was no link between insomnia and celiac disease. Despite not having major depression, both undiagnosed and diagnosed celiac disease patients who participated reported a high level of mental, emotional and physical limitation when compared to general public.

The study suggests that even though they may not be diagnosed with depression, they could have a significant treatment burden and difficulties coping with the symptoms. The authors said that there should be more research on the presence of psychiatric conditions among non-celiac gluten-free diet and celiac disease after using the diet to understand the role of gluten.