Background

Individuals living with coeliac disease generally experience a remission of symptoms after adopting the gluten-free diet but often report substantial treatment burden and ongoing quality of life issues. Psychosocial factors have been suggested to play a significant role in post-diagnosis quality of life but have yet to be systematically reviewed.

Aim

To review the evidence for psychosocial factors associated with quality of life in adult coeliac disease cohorts.

Methods

Studies were identified via systematic searches of eight databases (MEDLINE, Embase, Emcare, PsycINFO, Ovid Nursing, CINAHL, Informit Health Collection, Cochrane Library) in May 2019.

Results

Fourteen studies were included involving 3372 participants (80.2% female, mean age = 46.4 years). Symptoms of depression and anxiety were the most examined psychosocial factors across all studies. Quality of life was differentially associated with psychological distress, illness perceptions, coping, and attitudes/behaviours regarding food and the gluten-free diet.

Conclusion

Several psychosocial factors are associated with quality of life in adults living with coeliac disease. Current evidence suggests these factors are interrelated and may influence quality of life directly, via reduced psychological well-being, and indirectly, via reduced adherence to the gluten-free diet. Future research is needed to examine these processes concurrently, with the aim of elucidating the psychosocial mechanisms underlying post-diagnosis well-being and identifying potential targets for psychosocial intervention.

中文翻译：

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系统评价：探讨心理社会因素对患有乳糜泻的成人生活质量的影响

背景

患有乳糜泻的人在采用无麸质饮食后通常会出现症状缓解，但经常报告巨大的治疗负担和持续的生活质量问题。心理社会因素已被认为在诊断后的生活质量中发挥重要作用，但尚未得到系统评价。

目标

回顾成人乳糜泻队列中与生活质量相关的心理社会因素的证据。

方法

2019 年 5 月，通过对八个数据库（MEDLINE、Embase、Emcare、PsycINFO、Ovid Nursing、CINAHL、Informit Health Collection、Cochrane 图书馆）的系统搜索确定了研究。

结果

纳入 14 项研究，涉及 3372 名参与者（80.2% 为女性，平均年龄 = 46.4 岁）。在所有研究中，抑郁和焦虑症状是检查最多的社会心理因素。生活质量与心理困扰、疾病认知、应对以及对食物和无麸质饮食的态度/行为存在差异。

结论

一些心理社会因素与患有乳糜泻的成年人的生活质量有关。目前的证据表明，这些因素是相互关联的，可能通过降低心理健康直接影响生活质量，并通过降低对无麸质饮食的依从性间接影响生活质量。未来的研究需要同时检查这些过程，目的是阐明诊断后幸福感的心理社会机制，并确定心理社会干预的潜在目标。