a Department of Medical Science and Public Health , University of Cagliari , Cagliari , Italy.
b Center for the Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy.
Int Rev Psychiatry. 2017 Oct;29(5):489-503. doi: 10.1080/09540261.2017.1314952. Epub 2017 Jul 6.
Coeliac Disease (CD) is an autoimmune disease in which an environmental factor, gluten, triggers a pathological reaction. It results in intra- and entra-intestinal manifestations of disease, including, most frequently, diarrhoea, weight loss, and anaemia. CD occurs in ∼1% of the western population, being one of the most common autoimmune lifelong disorders, and may present with a variety of psychiatric comorbidities. Psychiatric comorbidity in CD often complicates the diagnosis, reduces the quality-of-life, and worsens the prognosis of affected patients. This review summarizes the epidemiological studies that underline this connection, and focuses on the potential mechanisms related to this comorbility, such as nutritional deficiencies, immune responses, interference in brain processes, and dysfunctions in the gut-brain axis. Factors that play a central role on patients' quality of life, psychological well-being and adherence are presented. Finally, evidence of regression in psychiatric symptoms following the introduction of a gluten-free diet is underlined as well.
乳糜泻(CD)是一种自身免疫性疾病,其中环境因素麸质会引发病理性反应。它会导致肠内和肠外疾病表现,包括最常见的腹泻、体重减轻和贫血。CD 在西方人群中的发病率约为 1%,是最常见的自身免疫性终身疾病之一,可能伴有多种精神共病。CD 中的精神共病常常使诊断复杂化,降低受影响患者的生活质量,并使预后恶化。这篇综述总结了强调这种联系的流行病学研究,并侧重于与这种共病相关的潜在机制,例如营养缺乏、免疫反应、对大脑过程的干扰以及肠道-大脑轴的功能障碍。还介绍了对患者生活质量、心理幸福感和依从性起核心作用的因素。最后,强调了在引入无麸质饮食后精神症状的消退证据。
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