Department of Oncology, China Academy of Chinese Medical Sciences Guang' anmen Hospital, 100053, Beijing, China.
Department of Anesthesiology, Hekou District People's Hospital, 257200, Dongying City, Shandong Province, China.
Int J Colorectal Dis. 2023 Nov 22;38(1):271. doi: 10.1007/s00384-023-04563-x.
Current studies on the association between fecal incontinence (FI) and depression are very limited, and most of them are restricted to women or elderly patients. This study aims to evaluate in detail the association between FI and depression among US adults.
13,480 adults aged 20 years and older were selected from the National Health and Nutrition Examination Survey 2005-2010. Monthly loss of solid, liquid, or mucous stool was defined as FI. Clinical depression and depression severity were assessed by the validated Patient Health Questionnaide-9 (PHQ-9). Models of multivariate logistic regression were used to calculate adjusted odds ratios (ORs). A subgroup analysis was carried out to ensure that the results were stable.
After adjusting for covariates such as demographics, risk behaviors and associated comorbidities, the PHQ-9 score and clinical depression were both significantly associated with FI, with ORs and 95%CIs of 1.11 (1.10-1.13) and 3.01 (2.53-3.57). Depression of all severities was also significantly associated with FI. The ORs and 95%CIs of FI with mild depression, moderate depression, and moderately severe to severe depression were 2.29 (1.96-2.68), 3.44 (2.77-4.27) and 4.65 (3.61-6.00), respectively. Subgroup analyses showed no statistically significant interactions (P > 0.05).
In conclusion, FI significantly associated with depression of any severity. Like the elderly or female patients with FI, young and middle-aged or men with FI are also at high risk of depression and should also be the focus of depression screening and early intervention.
目前关于粪便失禁（FI）与抑郁之间关联的研究非常有限，且大多数研究仅限于女性或老年患者。本研究旨在详细评估美国成年人中 FI 与抑郁之间的关联。
从 2005-2010 年全国健康和营养调查中选择了 13480 名年龄在 20 岁及以上的成年人。每月有固体、液体或黏液粪便丢失定义为 FI。使用经过验证的患者健康问卷-9（PHQ-9）评估临床抑郁和抑郁严重程度。使用多变量逻辑回归模型计算调整后的优势比（OR）。进行了亚组分析以确保结果稳定。
在校正人口统计学、风险行为和相关合并症等混杂因素后，PHQ-9 评分和临床抑郁均与 FI 显著相关，OR 值和 95%CI 分别为 1.11（1.10-1.13）和 3.01（2.53-3.57）。所有严重程度的抑郁也与 FI 显著相关。轻度、中度和中重度至重度抑郁的 FI 相关 OR 值和 95%CI 分别为 2.29（1.96-2.68）、3.44（2.77-4.27）和 4.65（3.61-6.00）。亚组分析未显示出统计学显著的交互作用（P>0.05）。
总之，FI 与任何严重程度的抑郁显著相关。与 FI 的老年或女性患者一样，FI 的年轻和中年或男性患者也存在较高的抑郁风险，也应成为抑郁筛查和早期干预的重点。
