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美国成年人便秘与自杀意念的关联及抑郁的部分中介作用。

Association of constipation with suicidal ideation among US adults and the partial mediating role of depression.

作者信息

Wang Pengfei, Wang Yan, Li Hong, Gao Feng, Huang Xiaojie, Ye Ying, Yan Xiaohua, Jin Yishun

机构信息

Hemorrhoids Department of Traditional Chinese Medicine, Fuzhou University Affiliated Provincial Hospital, 134 East Street, Gulou District, Fuzhou, 350001, China.

School of Medicine, Fuzhou University, 2 Wulong Jiangbei Avenue, Fuzhou, 350108, China.

出版信息

Sci Rep. 2025 Mar 29;15(1):10936. doi: 10.1038/s41598-025-95252-y.

Abstract

The association between constipation and suicidal ideation remains inadequately explored. This study aims to investigate the potential correlation between constipation and suicidal ideation in US adults, while assessing the mediating role of depression.For this cross-sectional study, a total of 13,493 adults aged 20 years and older were included from the National Health and Nutrition Examination Survey 2005-2010. The definition of constipation was defined by considering the consistency or frequency of stool. The ninth item on the Patient Health Questionnaire-9 (PHQ-9) evaluated suicidal ideation, and depression was evaluated using the PHQ-8 score. Adjusted odds ratios (ORs) were calculated using multivariate logistic regression models. Sensitivity analysis was performed to ensure stable results. Furthermore, study employed mediation analysis to examine the effect of constipation on suicidal ideation through depression. The bootstrapping method was used to assess the significance of the mediation effect. After controlling for demographic factors, risk behaviors, comorbidities, dietary intake, and relevant medications, constipation was associated with an increased risk of suicidal ideation (OR 1.41, 95%CI 1.08-1.83, P = 0.011). Sensitivity analyses showed the stability of the results. Moreover, mediation analysis demonstrated a significant direct effect of constipation on suicidal ideation (P = 0.016), with depression playing a partial mediating role in this interaction (40.81%, P < 0.0001). In conclusion, this study demonstrated a significant association between constipation and suicidal ideation, with depression serving as a partial mediator in this relationship. Further prospective longitudinal studies are essential to establish a definitive causal relationship between these factors so as to guide the development and implementation of targeted intervention strategies.

摘要

便秘与自杀意念之间的关联仍未得到充分研究。本研究旨在调查美国成年人中便秘与自杀意念之间的潜在相关性,同时评估抑郁的中介作用。

在这项横断面研究中,从2005 - 2010年国家健康与营养检查调查中纳入了总共13493名20岁及以上的成年人。便秘的定义是通过考虑粪便的稠度或频率来确定的。患者健康问卷-9(PHQ-9)的第九项评估自杀意念,抑郁则使用PHQ-8评分进行评估。使用多变量逻辑回归模型计算调整后的优势比(OR)。进行敏感性分析以确保结果稳定。此外,本研究采用中介分析来检验便秘通过抑郁对自杀意念的影响。采用自抽样法评估中介效应的显著性。

在控制了人口统计学因素、风险行为、合并症、饮食摄入和相关药物后,便秘与自杀意念风险增加相关(OR 1.41,95%CI 1.08 - 1.83,P = 0.011)。敏感性分析显示了结果的稳定性。此外,中介分析表明便秘对自杀意念有显著的直接效应(P = 0.016),抑郁在这种相互作用中起部分中介作用(40.81%,P < 0.0001)。

总之,本研究表明便秘与自杀意念之间存在显著关联,抑郁在这种关系中起部分中介作用。进一步的前瞻性纵向研究对于确定这些因素之间的明确因果关系至关重要,以便指导针对性干预策略的制定和实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/322c/11954943/fb30289e99ef/41598_2025_95252_Fig1_HTML.jpg

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