Background and objective: accumulating evidence based on scarce studies suggests that the relation between depression and functional constipation is possible. However, more studies in order to provide more reliable evidence are needed. About one-third of depressed people experience constipation and, it has a key role in reducing the perceived quality of life of the affected individuals. In the current study, therefore, we aimed to evaluate whether depression is associated with higher risk of functional constipation and whether it is gender specific.
Methods: This cross-sectional study was carried out among 3362 adults aged 18–55 years. In this study, functional gastrointestinal symptoms were determined using a Iranian reliable and valid version of the modified Rome III questionnaire. The Iranian validated version of Hospital Depression Scale (HADS) was used to evaluate psychological health. Scores of 8 or more on depression subscale in the questionnaire were considered to indicate the presence of depression. Self-administered questionnaires have been used to collect information regarding age, sex, marital status, education level, anthropometric measures, smoking, physical activity, antipsychotic medications use, dietary intakes. History of any predisposing chronic diseases including diabetes mellitus and cardiovascular diseases was also asked. Simple and binary logistic regression were used for data analysis.
Results: mean ± SD age of participants was 36.29 ± 7.87 years and 58.5% were female. The prevalence of depression and constipation in our study sample was 28.6% and 33.6%, respectively.
In crude model, in total sample depressed people showed higher significant risk of constipation OR=1.97 (95%CI:1.66-2.33). Although, we observed a significant association between depression and constipation in both genders, however the association was stronger in men than women (OR: 2.64; 95%CI: 1.91, 3.64 vs. OR: 1.52; 95%CI: 1.24, 1.86).
In the full adjusted model, in total sample depressed people showed higher significant risk of constipation Adjusted OR=1.69 (95%CI:1.37-2.09). Although, we observed a significant association between depression and constipation in both genders, however the association was stronger in men than women (AOR: 2.28; 95%CI: 1.50, 3.63 vs. AOR: 1.55; 95%CI: 1.21, 1.99).
Conclusion: Our study showed depressed people are at higher significant risk affecting by constipation. Our study findings justify mental health evaluation in all patients with functional gastrointestinal disorders particularly among constipated individuals.