Exploring the mediating role of self-compassion in the relationship between emotional distress and quality of life in celiac disease

Abstract

Celiac disease is a chronic autoimmune condition with gastrointestinal and extraintestinal symptoms, often impairing physical and psychological well-being. Although a strict gluten-free diet remains the only effective treatment, many patients continue to experience persistent, distressing symptoms. Psychological difficulties—particularly anxiety and depression—are highly prevalent among individuals with celiac disease. Self-compassion has been suggested as a positive psychological resource that may influence the impact of anxiety and depression on psychological and social quality of life in this population. This study aimed to investigate whether self-compassion mediates the relationships between anxiety, depression, and the psychological and social dimensions of quality of life in individuals with celiac disease. A cross-sectional study was conducted with 198 adult celiac patients recruited from Taleghani Hospital in Tehran, Iran. Participants completed validated measures of anxiety, depression, self-compassion, and quality of life. Mediation analyses were performed using the R lavaan package. Self-compassion fully mediated the relationship between anxiety and psychological quality of life ( P < 0.001), and partially mediated the relationship between depression and psychological quality of life ( P < 0.001). Depression significantly predicted social quality of life, but self-compassion showed no significant mediation for social QoL ( P > 0.05). Self-compassion mitigates the impact of anxiety and depression on psychological QoL but not social QoL, while depression strongly impairs social functioning. To enhance QoL in celiac disease, self-compassion therapy could be integrated into clinical care to improve psychological well-being, while cognitive-behavioral or group-based interventions should be explored to address depression’s social impact more effectively.