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Anxiety after coeli...
Anxiety after coeliac disease diagnosis predicts mucosal healing : a population-based study
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- Ludvigsson, Jonas F., 1969- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, UK; Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York City, USA
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- Lebwohl, Benjamin (author)
- Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York City, USA
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- Chen, Qi (author)
- Karolinska Institutet
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- Bröms, Gabriella (author)
- Karolinska Institutet
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- Wolf, Randi L. (author)
- Department of Health & Behavior Studies, Program in Nutrition, Teachers College, Columbia University, New York City, USA
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- Green, Peter H. R. (author)
- Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York City, USA
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- Emilsson, Louise (author)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston Massachusetts, USA; Department of Health Management and Health Economy, Institute of Health and Society, University of Oslo, Oslo, Norway; Centre for Clinical Research, Vårdcentralen Värmlands Nysäter, Värmlands Nysäter, Sweden
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(creator_code:org_t)
- 2018-10-04
- 2018
- English.
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In: Alimentary Pharmacology and Therapeutics. - : John Wiley & Sons. - 0269-2813 .- 1365-2036. ; 48:10, s. 1091-1098
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Abstract
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- Background: Coeliac disease has been linked to anxiety and depression. However, their association with mucosal healing is unknown.Aim: To examine the relationship between anxiety, depression and mucosal healing in coeliac disease.Methods: Between 1969 and 2008, we collected data on all small intestinal biopsies with villous atrophy from Sweden's 28 pathology departments. We restricted our cohort to individuals with data on follow-up biopsy (either persistent villous atrophy [n = 3317] or mucosal healing [n = 4331]). Through Cox regression, we estimated hazard ratios (HRs) for anxiety or depression.Results: Conclusion APPENDIX During follow-up, 123 (2.8/1000 person-years) individuals with mucosal healing had developed anxiety, compared to 94 (2.1/1000 person-years) with persistent villous atrophy. Mucosal healing was hence associated with a higher risk of future anxiety (HR = 1.49; 95% CI = 1.12-1.96). Similarly, 167 (3.8/1000 person-years) individuals with mucosal healing developed depression, compared to 148 (3.3/1000 person-years) with persistent villous atrophy, corresponding to a HR of 1.25 (95% CI = 0.99-1.59). Mucosal healing was more common in individuals with prior diagnoses of anxiety or depression before follow-up biopsy. Anxiety diagnosed between diagnostic and follow-up biopsy for coeliac disease was associated with an almost nine-fold increased chance of mucosal healing (odds ratio = 8.94; 95%CI = 2.03-39.27).Conclusion: Anxiety and depression are more common in coeliac disease patients with mucosal healing, both before and after follow-up biopsy, an association potentially mediated through more vigilant compliance with a gluten-free diet. This finding raises concern that achieving the goal of mucosal healing may come at a cost of an increased risk of mood disorders.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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