Quality of life and depressive state in patients with celiac disease: A case-control study

The objective of this study was to evaluate the quality of life (QoL) of celiac patients, their predisposition to depression, and possible related factors.

The study was planned as a case-control study and conducted between May 2023 and August 2023 at Umraniye Training and Research Hospital, Istanbul. The study included 81 patients with celiac disease (CD) aged 18-65 years who were followed up at the Gastroenterology outpatient clinic and 79 healthy controls who were admitted to the Family Medicine Outpatient Clinic. Participants were administered the Celiac Disease Questionnaire (CDQ), the World Health Organization Quality of Life Scale-Short Form (WHOQOL-BREF), and the Beck Depression Inventory (BDI). Statistical analysis was performed using SPSS 24 (Statistical Package for the Social Sciences).

The study was conducted with 160 participants, of whom 73.8 % (n = 118) were female and 26.3 % (n = 42) were male. Age and gender distributions were similar. The celiac group had significantly lower scores of the WHOQOL-BREF "Overall Health" subscale compared to healthy controls (p = 0.004, Cohen's d = 0.46). However, no significant differences were observed in other WHOQOL-BREF subscales or depression levels (p > 0.05). In the celiac group, higher education levels (undergraduate and postgraduate) were associated with better QoL scores (η² = 0.11, p = 0.015), while lower education was linked to higher depression scores (p = 0.019). A strong negative correlation was found between CDQ scores and BDI scores (r = -0.529, p = 0.001), indicating that higher depression levels were associated with lower QoL.When controlled for confounding variables, gender and CD turned out to be independently related to overall health subscale scores.

In patients with CD, both the QoL scale CDQ and the WHOQOL-BREF scores were found to be ahead of the curve in our study. It was also observed that the WHOQOL-BREF scale "overall health" subscale score was lower in celiac patients, while other sub-parameters and depressive symptoms were comparable to healthy individuals The lower "Overall Health" subscale scores highlight the need for targeted interventions.