{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:15:38Z","timestamp":1792059338102,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T00:00:00Z","timestamp":1538611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006736","name":"Universitetssjukhuset \u00d6rebro","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006736","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coeliac disease has been linked to anxiety and depression. However, their association with mucosal healing is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the relationship between anxiety, depression and mucosal healing in coeliac disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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\u2010up biopsy (either persistent villous atrophy [n\u00a0=\u00a03317] or mucosal healing [n\u00a0=\u00a04331]). Through Cox regression, we estimated hazard ratios (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      s) for anxiety or depression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During follow\u2010up, 123 (2.8\/1000 person\u2010years) individuals with mucosal healing had developed anxiety, compared to 94 (2.1\/1000 person\u2010years) with persistent villous atrophy. Mucosal healing was hence associated with a higher risk of future anxiety (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.49; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.12\u20101.96). Similarly, 167 (3.8\/1000 person\u2010years) individuals with mucosal healing developed depression, compared to 148 (3.3\/1000 person\u2010years) with persistent villous atrophy, corresponding to a\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      of 1.25 (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a00.99\u20101.59). Mucosal healing was more common in individuals with prior diagnoses of anxiety or depression before follow\u2010up biopsy. Anxiety diagnosed between diagnostic and follow\u2010up biopsy for coeliac disease was associated with an almost nine\u2010fold increased chance of mucosal healing (odds ratio\u00a0=\u00a08.94; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a02.03\u201039.27).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anxiety and depression are more common in coeliac disease patients with mucosal healing, both before and after follow\u2010up biopsy, an association potentially mediated through more vigilant compliance with a gluten\u2010free diet. This finding raises concern that achieving the goal of mucosal healing may come at a cost of an increased risk of mood disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.14991","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T23:59:23Z","timestamp":1538783963000},"page":"1091-1098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Anxiety after coeliac disease diagnosis predicts mucosal healing: a population\u2010based study"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-5602","authenticated-orcid":false,"given":"Jonas F.","family":"Ludvigsson","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"},{"name":"Department of Paediatrics \u00d6rebro University Hospital \u00d6rebro Sweden"},{"name":"Division of Epidemiology and Public Health School of Medicine University of Nottingham City Hospital Nottingham UK"},{"name":"Department of Medicine Celiac Disease Center Columbia University College of Physicians and Surgeons New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Lebwohl","sequence":"additional","affiliation":[{"name":"Department of Medicine Celiac Disease Center Columbia University College of Physicians and Surgeons New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Br\u00f6ms","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Internal Medicine Danderyd Hospital Stockholm Sweden"},{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randi L.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Health &amp; Behavior Studies Program in Nutrition Teachers College Columbia University New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H. R.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Medicine Celiac Disease Center Columbia University College of Physicians and Surgeons New York City New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9137-2800","authenticated-orcid":false,"given":"Louise","family":"Emilsson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T.H. 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