Adult coeliac patients living in a defined area of Sweden were examined for a history of major psychiatric illness occurring before the coeliac disease had been diagnosed. Eight of 42 patients without dermatitis herpetiformis (19%) and one medical control subject had attended a psychiatric clinic over a 10-year period for neurotic disorders (p < 0.05), mostly depression. Our study shows that psychiatric illness may be severe in undiagnosed adult coeliac patients. It was found to be the commonest reason for granting disability pension in our series, having occurred in altogether six patients.