Self-Related Cognitive Schemas, Negative Self-View, and Perceived Psychosocial Burden in Adults with Celiac Disease:...

Background: Self-related cognitive schemas may influence psychological adaptation to chronic illness. However, their role in adults with celiac disease (CD) remains poorly understood. We aimed to assess cognitive schemas and depressive symptoms in adults with CD compared with healthy controls, and to examine their associations with perceived disease burden. Methods: This cross-sectional comparative study included 96 adults with CD and 96 healthy controls. Participants completed the Cognitive Triad Inventory (CTI) and Beck Depression Inventory (BDI), and sociodemographic and clinical data were collected. Perceived disease- and diet-related burden was assessed using investigator-developed single-item measures. Results: The mean age at CD diagnosis was 33.6 (SD 13.4) years, and the mean duration of symptoms before diagnosis was 5.4 (SD 5.1) years. Adults with CD reported higher depressive symptom scores than healthy controls (8.4 (SD 7.9) vs. 6.6 (SD 8.0); Mann-Whitney U = 3850.5, Z = 1.99, Cohen's d = 0.29, p = 0.046). No significant between-group differences were observed in total CTI scores or its Self-view, World-view, or Future-view subscales. After adjustment for age, sex, educational level, marital status, and employment status, neither BDI nor CTI scores were independently associated with group membership. Exploratory bivariate analyses within the CD group showed that higher Self-view scores were associated with lower perceived negative impact of gluten-free diet requirements on family life (rS = -0.29, p = 0.004) and lower perceived impact of CD symptoms and disease exacerbations on everyday life (rS = -0.31, p = 0.002). These associations remained statistically significant after Bonferroni correction. Conclusions: Adults with CD reported slightly higher depressive symptom levels than healthy controls, whereas cognitive schemas did not differ significantly between groups. The observed associations between CTI Self-view and selected indicators of perceived disease- and diet-related burden warrant further investigation, but do not establish a causal contribution of self-view to disease burden.