Hauser et al identified a number of predictors associated with a reduced quality of life for an adult with celiac disease. These can help identify a patient who may require more aggressive management. The authors are from Klinikum Saarbrucken, Friedrich Schiller Universitat Jena, and Johan Wolfgang von Goethe-Universitat Frankfurt in Germany.


Patient selection: adult (age >= 18 years) with celiac disease


Predictors of a reduced quality of life:

(1) younger age at diagnosis (perhaps indicating more severe disease, or resulting in a more difficult psychological adaptation)

(2) poor compliance with gluten-free diet

(3) presence of physical comorbid conditions (perhaps as a result of poor compliance)

(4) presence of mental comorbid conditions (anxiety, depression, other)

(5) dissatisfaction with information from health care providers


Interventions to improve quality of life:

(1) Actively work to improve compliance with diet and therapy.

(2) Address issues of anxiety and depression.

(3) Consider the need for specialized care (specialized providers, specialized sources of information)

(4) Consider benefits of a support group.



(1) Which came first? (or does it matter in someone spiraling out of control?)

(2) How many patients may have been misdiagnosed? (which would result in a person failing to improve despite dietary compliance)

(3) Are the issues similar to those seen in juvenile diabetics?


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