Ansiedade e depressão em indivíduos com doença celíaca

Abstract

This study aimed to investigate the presence of depression and anxiety among celiac patients. It was a cross-sectional and exploratory study with a quantitative approach, performed with celiac patients between May to September 2017 through an interview. Data collection was based on an instrument, which had items related to sociodemographic and clinical variables. Participants diagnosed with CD, 18 years of age or older and living in the state of Ceará, Brazil, were included in this research. The exclusion criterion was being a celiac patient with some cognitive limitation that hinders data collection. Statistical analysis was performed in SPSS, version 22.0. Sociodemographic and clinical variables were analyzed by averages of absolute frequencies, percentages, measures of central tendency and dispersion. To evaluate the association between the clinical variables, Chi-square test was applied for frequencies greater than five; otherwise, Fisher's exact probability test was used. Prevalence Ratio was measured by the calculation of prevalence. Regarding the difference between averages, Kolmogorov-Smirnov tests were used to verify normality and the Levene test to verify homoscedasticity. Based on the results, the T or Mann-Whitney test was performed to verify the average/median difference. Spearman's test was used to evaluate the correlation between the average of the stations and the depression and anxiety scales. The recommendations from the Brazilian resolution number 466/2012 were followed. A total of 83 celiac participants were interviewed and were predominantly white, female, living in Fortaleza, aged 33 years old, reported having no partner; had 18 years of formal education, paid employment and income of up to R$ 2.333,33, and been a member of support associations. Anxiety and depression were present in 62.7% and 34.9% of the sample, respectively. The variables that showed the highest prevalence were Ineffective management of the celiac disease with 95.2% and Perceived seriousness of condition with 71.1%. Moreover, most of the celiac patients presented Daily activities with 56.6% and Daily obstacles for gluten-free diet with 55.4%. Participants with Perceived seriousness of condition were 3.7 and 10.7 times more likely to present higher scores on the anxiety and depression scales, respectively. The number of symptoms per participant is directly related to higher scores on the depression and anxiety scale. When the correlation of the presence of Anxiety with other variables was measured, it was observed the predominance of three: Ineffective management of the celiac disease with 98.1%, Perceived seriousness of condition with 75.0%, Daily obstacles to gluten-free diet with 63.4% and Daily activities with 55.8%. It was also identified that in the presence of the variable Depression there was prevalence in Ineffective management of the celiac disease with 100.0%, Perceived seriousness of condition with 82.8% and Daily Obstacles to gluten-free diet with 69.0%. Therefore, a relationship between the presence of the variables of psycho-affective, daily and family factors and the development of anxiety and depression could be perceived. In the context of chronic health conditions, it is necessary to increase the attention of nurses regarding permanent care and in the implication of the celiac disease in the quality of life of celiac patients.