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Constipation is associated with depression of any severity, but not with suicidal ideation: insights from a large cross-sectional study

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Abstract

Objective

The association between constipation and depression or suicidal ideation (SI) has not been adequately studied. This study aims to examine whether constipation is associated with depression or SI in US adults.

Method

4,562 adults aged 20 and older were selected from the National Health and Nutrition Examination Survey 2009–2010 for the sample. The Bowel Health Questionnaire provided constipation information. Clinical depression and depression severity were assessed by the validated Patient Health Questionnaide-9 (PHQ-9), and item 9 of the PHQ-9 assessed SI. Adjusted odds ratios (ORs) were calculated using multivariate logistic regression models. Stability of the results was ensured by a subgroup analysis.

Result

After adjusting for covariates such as demographics, risk behaviors, associated comorbidities, dietary intake, and related medications, the PHQ-9 score and clinical depression were both significantly associated with constipation, with ORs and 95%CIs of 1.13 (1.10–1.16) and 3.76 (2.65–5.34). Depression of all severities was also significantly associated with constipation. The ORs and 95%CIs of constipation with mild depression, moderate depression, and moderately severe to severe depression were 2.21 (1.54–3.16), 3.69 (2.34–5.81) and 6.84 (4.19–11.15), respectively. Subgroup analyses showed no statistically significant interactions (P > 0.05), and the association was stronger in men than in women (OR: 7.81, 95%CI: 3.67–16.61 vs OR: 3.46, 95%CI: 2.31–5.19). The association between constipation and SI was not significant (OR: 1.36, 95%CI: 0.78–2.37).

Conclusion

In conclusion, constipation was significantly associated with depression of any severity, but not with SI, suggesting that enough attention should be paid to the emotional and psychological status of patients with constipation, especially male patients.

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Data availability

Publicly available and de-identified data used in this analysis can be found in the CDC National Center for Health Statistics NHANES database at https://wwwn.cdc.gov/nchs/nhanes/Default.as px.

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Acknowledgements

We thank Dr. Liu Jie (People’s Liberation Army of China General Hospital,Beijing, China) and Dr.Yang Qilin (The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China) for helping in this revision.

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Authors and Affiliations

  1. Department of Oncology, China Academy of Chinese Medical Sciences Guang’ Anmen Hospital, Beijing, 100053, China

    Yan Wang

  2. Department of Nursing, Wuxi Medical College, Jiangnan University, 1800 Li Hu Avenue, Wuxi, 214062, China

    Xia Shen

  3. Department of Anorectal Surgery, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, 100091, China

    Pengfei Wang

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The authors’ responsibilities were as follows—Pengfei Wang, Xia Shen, Yan Wang: contributed to study planning, data analyses and drafting of the manuscript; Pengfei Wang, Yan Wang: contributed to study planning and manuscript development; All authors: read and approved the final manuscript.

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Correspondence to Pengfei Wang.

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Institutional Research Ethics Review Board of the CDC approved the protocol for the NHANES survey. The protocol was approved by the NCHS Ethics Review Board with informed consent from all participants.

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Wang, Y., Shen, X. & Wang, P. Constipation is associated with depression of any severity, but not with suicidal ideation: insights from a large cross-sectional study. Int J Colorectal Dis 38, 231 (2023). https://doi.org/10.1007/s00384-023-04520-8

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