Anxiety and depression: a study of psychoaffective, family-related, and daily-life factors in celiac individuals

Guedes, Nirla Gomes; Silva, Leonardo Alexandrino da; Bessa, Cristina Costa; Santos, Jorgiana Cavalcanti dos; Silva, Viviane Martins da; Lopes, Marcos Venícios de Oliveira

doi:10.1590/0034-7167-2020-0086

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (Suppl 1) • 2020 • https://doi.org/10.1590/0034-7167-2020-0086 copy

Anxiety and depression: a study of psychoaffective, family-related, and daily-life factors in celiac individuals

Cuadros de ansiedad y depresión: estudio de factores psicoafectivos, familiares y cotidianos en indivíduos celíacos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the prevalence of anxiety and depression and its association with psychoaffective, family-related, and daily-life variables of celiac individuals.

Methods:

Crosssectional study, developed with 83 celiac patients in Fortaleza. An instrument was applied with variables grouped in the categories: psychoaffective, family-related, and daily-life.

Results:

It was found that 52 celiac patients (62.7%) had anxiety and 29 (34.9%) had depression. The clinical conditions found and the number of symptoms increased the chance of anxiety/depression. The predominant factors in those with anxiety were Lack of control of the celiac disease (98.1%), Perceived clinical condition (75.0%), Daily obstacles for maintaining a gluten-free diet (63.4%), and Daily activities (55.8%). In those with depression, there was a higher prevalence of Lack of control of the celiac disease (100.0%), Perceived clinical condition (82.2%), and Daily obstacles for maintaining a gluten-free diet (69.0%).

Conclusion:

Celiac individuals with anxiety and depression frameworks presented a higher frequency of Perceived clinical condition, Insufficient social support (psychoaffective factors) and Daily obstacles for maintaining a gluten-free diet (daily-life factor).

Descriptors:
Celiac Disease; Chronic Disease; Diet, Gluten-Free; Depression; Anxiety

Variables				n	%
1. Psychoaffective factors
Lack of knowledge about the pathology
No				83	100
Yes				0	0
Perceived clinical condition
No				24	28.9
Yes				59	71.1
Insufficient social support
No				68	81.9
Yes				15	18.1
2. Family-related factors
Unsatisfactory shared care
No				81	97.6
Yes				2	2.4
Family support
No				40	48.2
Yes				43	51.8
3. Daily-life factors
Lack of control of the celiac disease
No				4	4.8
Yes				79	95.2
Daily activities
No				36	43.4
Yes				47	56.6
Daily obstacles in the maintenance of the GFD
No				37	44.6
Yes				46	55.4
4. Anxiety
No				31	37.3
Yes				52	62.7
5. Depression
No				54	65.1
Yes				29	34.9
	Medium	SD	Median	IIQ	p *value^ * Kolmogorov-Smirnov's test.**
6. Social support (affective)	4.80	0.598	5.0	0.0	0.000
7. Social support (positive social interaction)	4.49	0.806	5.0	0.7	0.000
8. Social support (emotional)	4.21	0.968	4.7	1.5	0.000
9. Total anxiety score	14.62	9.831	14.0	12.0	0.082
10. Total depression score	9.84	6.80	10.0	9.0	0.033

Mean of the variable results	Anxiety scores	Depression scores	p value^* * Mann-Whitney's test;
1. Lack of knowledge about the pathology
Absent	19.88	20.63	^† † No statistic could be calculated; CD: Celiac Disease; GFD: Gluten-free diet.
Present	43.12	43.08
2. Perceived clinical condition
Absent	37.00	31.15	0.228
Present	44.03	46.42	0.009
3. Insufficient social support
Absent	41.25	39.56	0.546
Present	45.40	53.07	0.049
4. Unsatisfactory shared care
Absent	42.46	41.98	0.271
Present	23.50	42.75	0.964
5. Family support
Absent	47.18	45.69	0.059
Present	37.19	38.57	0.178
6. Lack of control of the CD
Absent	19.88	20.63	0.060
Present	43.12	43.08	0.069
7. Daily activities
Absent	41.03	43.14	0.748
Present	42.74	41.13	0.706
8. Daily obstacles in the maintenance of the GFD
Absent	38.42	34.07	0.224
Present	44.88	48.38	0.007

Variables	Anxiety				Statistics
	Ausente		Presente
	n	%	n	%
1. Lack of knowledge about the pathology
Absent	31	100	52	100
Present	0	0	0	0	^* * No statistic could be calculated.
Total	31	100.0	52	100.0
2. Perceived clinical condition
Absent	11	35.5	13	25	p = 0.308^† † Chi-squared test.
Present	20	64.5	39	75	OR = 1.650
Total	31	100.0	52	100.0	IC 95%: 0.627-4.340
3. Insufficient social support
Absent	27	87.1	41	78.9	p = 0.345^† † Chi-squared test.
Present	4	12.9	11	21.1	OR = 1.811
Total	31	100.0	52	100.0	IC 95%: 0.522-6.278
4. Unsatisfactory shared care
Absent	30	96.8	51	98.1	p = 1.00^‡ ‡ Fisher's exact test.
Present	1	3.2	1	1.9	OR = 0.588
Total	31	100.0	52	100.0	IC 95%: 0.035-9.753
5. Family support
Absent	11	35.5	29	55.8	p = 0.351^† † Chi-squared test.
Present	20	64.5	23	44.2	OR = 0.650
Total	31	100.0	52	100.0	IC 95%: 0.262-1.611
6. Lack of control of the CD
Absent	3	9.7	1	1.9	p = 0.144^‡ ‡ Fisher's exact test.
Present	28	90.3	51	98.1	OR = 5.464
Total	31	100.0	52	100.0	IC 95%: 0.543-55.03
7. Daily activities
Absent	13	41.9	23	44.2	p = 0.838^† † Chi-squared test. OR = 0.911
Present	18	58.1	29	55.8
Total	31	100.0	52	100.0	IC 95%: 0.371-2.238
8. Daily obstacles in the maintenance of the GFD
Absent	18	58.1	19	36.5	p = 0.056^† † Chi-squared test.
Present	13	41.9	33	63.4	OR = 2.405
Total	31	100.0	52	100.0	IC 95%: 0.968-5.972

Variables	Depression				Statistics
	Absent		Present
	n	%	n	%
1. Lack of knowledge about the pathology
Absent	54	100.0	29	100.0	^* * No statistic could be calculated.
Present	0	0.0	0	0.0
Total	54	100.0	29	100.0
2. Perceived clinical condition
Absent	19	35.2	5	17.2	p = 0.086^† † Chi-squared test.
Present	35	64.8	24	82.8	OR = 2.606
Total	54	100.0	29	100.0	IC 95%: 0.856-7.936
3. Insufficient social support
Absent	47	87.0	21	72.4	p = 0.099^† † Chi-squared test.
Present	7	13.0	8	27.6	OR = 2.558
Total	54	100.0	29	100.0	IC 95%: 0.820-7.977
4. Unsatisfactory shared care
Absent	53	98.1	28	96.5	p = 1.000^‡ ‡ Fisher's exact test.
Present	1	1.9	1	3.5	OR = 1.893
Total	54	100.0	29	100.0	IC 95%: 0.114-31.421
5. Family support
Absent	24	44.4	16	55.2	p = 0.351^† † Chi-squared test.
Present	30	55.6	13	44.8	OR = 0.650
Total	54	100.0	29	100.0	IC 95%: 0.262-1.611
6. Lack of control of the CD
Absent	4	7.4	0	0.0
Present	50	92.6	29	100.0	p = 0.292^‡ ‡ Fisher's exact test.
Total	54	100.0	29	100.0
7. Daily activities
Absent	21	38.9	15	51.7	p = 0.261^† † Chi-squared test.
Present	33	61.1	14	48.3	OR = 0.594
Total	54	100.0	29	100.0	IC 95%: 0.239-1.477
8. Daily obstacles in the maintenance of the GFD
Absent	28	51.9	9	31.0	p = 0.069^† † Chi-squared test.
Present	26	48.1	20	69.0	OR = 2.393
Total	54	100.0	29	100.0	IC 95%: 0.925-6.192

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[1] Corresponding author: Leonardo Alexandrino da Silva E-mail: alexandeinoleo@hotmail.com