Relationship between Depression and Constipation: Results from a Large Cross-sectional Study in Adults / 대한소화기학회지

Background/Aims@#Accumulating evidence based on a few studies suggests a relationship between depression and functional constipation. This study examined whether depression is associated with a higher risk of functional constipation and whether it is gender specific. @*Methods@#This cross-sectional study was carried out on 3,362 adults aged 18-55 years. In this study, functional gastrointestinal symptoms were determined using an Iranian reliable and valid version of the modified Rome III questionnaire. The Iranian validated version of the hospital anxiety and depression scale was used to evaluate the psychological health. Scores of eight or more on the depression subscale in the questionnaire were considered the presence of depression. Simple and multiple binary logistic regression were used for data analysis. @*Results@#The mean±SD age of participants was 36.29±7.87 years, and 58.5% were female. The prevalence of depression and constipation in the study sample was 28.6% and 23.9%, respectively. In the full adjusted model, in the total sample, depressed people showed a significantly higher risk of constipation; adjusted OR (AOR), 1.69 (95% CI, 1.37-2.09). Although a significant association was observed between depression and constipation in both genders, the association was stronger in men than women (AOR, 2.28; 95% CI, 1.50, 3.63 vs. AOR, 1.55; 95% CI, 1.21, 1.99). @*Conclusions@#These study findings showed that depressed people are at a significantly higher risk of being affected by constipation. The current study findings justify the importance of mental health evaluations in all patients with functional gastrointestinal disorders, particularly among constipated individuals.

Somatic Complaints Are Significantly Associated with Chronic Uninvestigated Dyspepsia and Its Symptoms: A Large Cross-sectional Population Based Study

BACKGROUND/AIMS: Somatization may influence persistence and severity of symptoms in gastrointestinal diseases. Some studies suggest that somatization is associated with chronic uninvestigated dyspepsia (CUD); however, the association is unclear. We aimed to determine the association between the profiles of somatic complaints with CUD and its symptoms. METHODS: In a cross-sectional study conducted on 4763 Iranian adults, somatic complaints were assessed using a comprehensive 31-items questionnaire. Patients with CUD were identified by the Rome III diagnostic criteria. Profiles of somatic complaints were derived from factor analysis. Logistic regression analysis was used to assess the relationship between extracted profiles with CUD and its symptoms. RESULTS: CUD, bothersome postprandial fullness, early satiation, and epigastric pain or burning was identified in 723 (15.2%), 384 (8.1%), 302 (6.3%), and 371 (7.8%) of the study population. The frequency of all 31 somatic complaints was significantly higher in patients with CUD compared with controls (P < 0.001), and the most frequent was severe fatigue (45.1%). The profiles of somatic complaints were extracted in 4 domains, including “psychological”, “gastrointestinal”, “neuro-skeletal”, and “pharyngeal-respiratory”. The psychological (OR, 1.49; 95% CI, 1.44–1.54), gastrointestinal (OR, 2.22; 95% CI, 2.09–2.37), neuro-skeletal (OR, 1.52; 95% CI, 1.44–1.59), and pharyngeal-respiratory (OR, 2.09; 95% CI, 1.94–2.25) profiles were significantly associated with greater odds of CUD. CONCLUSIONS: CUD and its symptoms are strongly associated with higher levels of somatic complaints and their related extracted profiles. This perhaps explains that why it can be difficult to treat, however further prospective investigations are required to confirm these associations.

[ effectiveness of emotion regulation intervention on emotional problems and quality of life among patients with functional gastrointestinal disorders]

The Unified treatment approach [UP], an emotion-focused cognitive-behavioral therapy that holds emotional processes as a central target of treatment, is applicable for disorders with strong emotional components. The aim of this study was to examine the effectiveness of emotion regulation intervention derivative from the UP on emotional problems and quality of life among patients with functional gastrointestinal disorders. The study was a randomized clinical trial. Sixteen patients with functional gastrointestinal disorders were entered in treatment process, in term of the qualification criteria. The intervention was conducted in 12 group sessions during 2 hours. The tests of DASS and SF-36 was used to evaluate the efficiency of intervention. Data were analyzed using descriptive statistics and covariance analysis. The results of the covariance analysis showed that there was significant decrease in severity of depression [p<0.01], anxiety [p <0.05] and stress [p <0.01] and also significant increase in quality of life [p <0.01] in intervention group. Emotional regulation intervention on the basis of the UP was effective in decrease of severity of emotional symptoms [depression, anxiety, stress] and increase of quality of life patients with psychosomatic disorders. So, the UP, transdiagnostic therapy have proper efficacy in improvement emotional regulation and quality of life patients with functional gastrointestinal disorders

On the relationship between alexithymia and depression and anxiety in psychiatric patients

Alexithymia means disability in expressing emotions. It is reported in a wide range of psychiatric and medical disorders. This study was conducted to evaluate the relationship of alexithymia with depression and anxiety in psychiatric patients. In this descriptive correlational study, 81 patients [62 females and 19 males] which were referred to a governmental psychiatric clinic in Isfahan city, center of Iran, in 2008, were selected by available sampling method. Samples assessed by Toronto alexithymia scale and hospital anxiety and depression scale. Data were analyzed by descriptive indices, Pearson s correlation coefficient and regression analyses. Pearson s correlation coefficient showed that two dimensions of alexithymia including difficulty in identifying feelings [P=0,001] and difficulty in describing feelings [P<0.014] had significant direct correlation with depression and anxiety, while dimension of externally-oriented thinking was not correlated with depression and anxiety [P=0.96]. Regression analysis showed that dimensions of alexithymia could not predict variations of depression and anxiety. The relationship of alexithymia with depression and anxiety emphasizes its relationship with psychological vulnerability indicators

Comparison of four different treatment options in the management of acute conversion disorder

Patients with conversion disorder may be seen by different specialists in various clinics and emergency situations. However, there are not sufficient studies on the most effective treatment for this disabling illness. In a clinical trial, we compared four treatment strategies; muscle relaxation, suggestion, hypnosis and intravenous diazepam infusion, in 80 patients with acute conversion disorder. Speed of recovery and number of the recurrences in a month following different treatment options were compared among groups. Recovery was significantly quicker with muscle relaxation compared to hypnosis and diazepam infusion. In patients with comorbidity of major depressive disorder, recovery was even faster. There was no statistically significant differences in the number of remissions or relapses among the four groups. All the four different treatment strategies brought about significant recovery. However, after treating patients with muscle relaxation, recovery was faster compared to other treatment methods

Add-on topiramate for the pharmacological management of schizophrenia: a double blind randomized clinical trial

Glutamate antagonists including anticonvulsant topiramate have been recommended for the pharmacological management of schizophrenia. A randomized, double-blind, placebo controlled clinical trial was performed on 32 patients diagnosed with schizophrenia [18-45 years old]. Baseline information was gathered on demographic characteristics, vital signs, height, weight, smoking habit, [past] psychiatric history, drug history and adverse effects to medication. Patients were randomly assigned to topiramate group [n=16] or placebo one [n=16]. Positive and negative syndrome scale [PANSS] was administered on each patient at baseline, on days 28 and 56. The mean total PANSS score in topiramate group was 96.87 [85.37-108.37] at baseline, 85.68 [74.67-96.70] on day 28 and 76.87[66.06-87.69] on day 56. These were 101.87 [90.37-113.37], 100.31 [89.29- 111.32] and 100.56 [89.74-111.37] respectively in placebo group. General linear model for repeated measure analysis showed that topiramate has lowered PANSS score significantly. Significant decline was also found in all three PANSS components [negative, positive and psychopathology symptoms]. Topiramate can therefore be used as an effective add-on medication in treating schizophrenia