Wang Pengfei, Shen Xia, Wang Yan, Jia Xiaoqiang
Department of Anorectal Surgery, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China.
Department of Nursing, Wuxi Medical College, Jiangnan University, Wuxi, China.
Front Psychiatry. 2023 Aug 15;14:1152435. doi: 10.3389/fpsyt.2023.1152435. eCollection 2023.
Current studies on the association between constipation and depression is still insufficient. In this study, we investigated the detailed association between constipation and major depression among American adults.
In this cross-sectional study, 12,352 adults aged 20 and older were selected from the National Health and Nutrition Examination Survey 2005-2010 for the sample. Constipation was defined as fewer than three defecation frequencies per week. For the assessment of major depression, the validated Patient Health Questionnaire-9 was used. Adjusted odds ratios (ORs) were calculated using multivariate logistic regression models. A subgroup analysis was carried out to ensure that the results were stable.
Of the 12,352 participants, 430 reported constipation, with a prevalence of 3.5%. Depression was reported in 1030 cases, indicating a prevalence rate of 8.3%. Patients with constipation were significantly more likely to have major depression (20.9%) than those without it (7.9%, < 0.001). After adjusting for age, sex, race/ethnicity, marital status, education level, body mass index, vigorous physical activity, alcohol consumption, smoking status, poverty income ratio, diabetes, selective serotonin reuptake inhibitor use, liver disease, heart disease, pulmonary disease, hypertension, arthritis, cancer, dietary fiber intake, moisture intake, total fat intake, carbohydrates intake, and protein intake, constipation is significantly associated with major depression (OR: 2.20, 95%CI: 1.68-2.87, < 0.001). Subgroup analyses by age, sex, dietary intake, risk behaviors, and common complications showed no statistically significant interactions ( > 0.05).
In conclusion, this study showed that constipation were significantly associated with depression. When treating patients with constipation, it is necessary for clinicians to screen and evaluate depression, and provide timely and effective intervention for patients with depression to avoid further deterioration of the condition.
目前关于便秘与抑郁症之间关联的研究仍不充分。在本研究中，我们调查了美国成年人中便秘与重度抑郁症之间的详细关联。
在这项横断面研究中，从2005 - 2010年美国国家健康与营养检查调查中选取了12352名20岁及以上的成年人作为样本。便秘定义为每周排便次数少于三次。对于重度抑郁症的评估，使用经过验证的患者健康问卷-9。采用多因素逻辑回归模型计算调整后的优势比（OR）。进行亚组分析以确保结果稳定。
在12352名参与者中，430人报告有便秘，患病率为3.5%。报告有抑郁症的有1030例，患病率为8.3%。便秘患者患重度抑郁症的可能性（20.9%）显著高于无便秘者（7.9%，P < 0.001）。在调整年龄、性别、种族/民族、婚姻状况、教育水平、体重指数、剧烈体育活动、饮酒、吸烟状况、贫困收入比、糖尿病、选择性5-羟色胺再摄取抑制剂使用情况、肝病、心脏病、肺病、高血压、关节炎、癌症、膳食纤维摄入量、水分摄入量、总脂肪摄入量、碳水化合物摄入量和蛋白质摄入量后，便秘与重度抑郁症显著相关（OR：2.20，95%CI：1.68 - 2.87，P < 0.001）。按年龄、性别、饮食摄入、风险行为和常见并发症进行的亚组分析显示无统计学显著交互作用（P > 0.05）。
总之，本研究表明便秘与抑郁症显著相关。在治疗便秘患者时，临床医生有必要筛查和评估抑郁症，并为抑郁症患者提供及时有效的干预，以避免病情进一步恶化。
