Abstract
Objective. Constipation is a prevalent problem in patients with psychiatric disorders; it reduces quality of life and may lead to severe complications. The prevalence distribution of constipation across all psychiatric diagnoses in patients with severe mental illness (SMI) has hardly been studied. The aim of this study is to estimate the association between psychiatric disorders and constipation in SMI inpatients. Methods. The strength of the association between constipation (based on use of laxatives) and DSM-IV psychiatric diagnosis was studied in a cross-sectional study with “adjustment disorders” as the reference group. The association was analyzed using logistic regression. Results. Of the 4728 patients, 20.3% had constipation. In the stratum of patients older than 60 years, all psychiatric categories except for substance related disorders were significantly associated with a higher prevalence of constipation (odds ratios ranging from 3.38 to 6.52), whereas no significant associations were found in the stratum of patients between 18 and 60 years (odds ratios ranging from 1.00 to 2.03). Conclusion. In the elderly, all measured psychiatric diagnoses are strongly associated with an increased prevalence of constipation. Physicians should be extra alert for constipation in SMI patients, independent of specific psychiatric diagnoses.
Highlights
Constipation is a prevalent symptom in the psychiatric population, with a reported two-year period prevalence of 36.3% in schizophrenic patients [1] and 57.7% in depressive patients [2]
This study shows that, in the elderly, all measured psychiatric diagnoses are significantly associated with constipation in comparison with patients with adjustment disorder
It can be hypothesized that these unhealthy lifestyle factors occur more frequently in elderly patients with psychiatric disorders [17], which may partially explain the results of this study
Summary
Constipation is a prevalent symptom in the psychiatric population, with a reported two-year period prevalence of 36.3% in schizophrenic patients [1] and 57.7% in depressive patients [2]. Constipation is a frequent problem in the psychiatric population, there is little attention for it in research. This is in contrast with the clinical consequences of constipation that can cause or aggravate many common digestive symptoms and complaints and may even lead to severe complications such as fecal impaction, bowel perforation, paralytic ileus, and death [4] and is associated with a decreased quality of life in a similar degree as depression and diabetes [5]. The burden of the disease makes early recognition and treatment of constipation of clinical importance
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