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.

Relationship between obesity and depression, anxiety and psychological distress among Iranian health-care staff

Background: Psychological-related disorders such as obesity are a key contributor to morbidity and mortality. Aims: To assess the association between general and abdominal obesity with depression and anxiety among Iranian health-care staff. Methods: This cross-sectional study was conducted under the framework of the Study on the Epidemiology of Psycho- logical Alimentary Health and Nutrition. A total of 4361 Iranian health-care staff were analyzed for general obesity and 3213 for central obesity. Overweight and obesity was defined as body mass index 25.0–29.9 and ≥ 30.0 kg/m2, respectively. Abdominal obesity was defined as waist circumference (WC) ≥ 88 cm for females and ≥ 102 cm for males. The Iranian validated versions of the Hospital Anxiety and Depression Scale and the General Health Questionnaire were used to assess depression and anxiety. Results: Stratified analysis by sex revealed no significant relationship between general obesity, depression and anxiety among males. However, we found an inverse association between abdominal obesity (WC > 102 cm) and severe depression among males. In females, abdominal obesity was significantly associated with anxiety, before and after taking confounders into account. No significant association was seen between abdominal obesity and psychological distress in either sex after controlling for potential confounders. Conclusions: Abdominal obesity was associated with anxiety in Iranian adult females but not in males. Further studies, particularly prospective research, are required to confirm these findings.

Adherence to Dietary Approaches to Stop Hypertension Eating Plan and Prevalence of Irritable Bowel Syndrome in Adults

Background/Aims@#Despite huge evidence on the link between adherence to dietary approaches to stop hypertension (DASH) eating pattern and several metabolic abnormalities, the association of this diet with irritable bowel syndrome (IBS) has not been investigated so far. We aim to examine the association between adherence to the DASH diet and prevalence of IBS symptoms and subtypes in adults. @*Methods@#This cross-sectional study was done among 3362 adult people in Isfahan, Iran. Usual dietary intakes were assessed using a validated 106-item dish-based semi-quantitative food frequency questionnaire. To investigate participants’ adherence to DASH-style diet, we created DASH score based on 8 main foods and nutrients emphasized or minimized in the DASH diet. Participants were classified into 3 categories according to their DASH-style diet scores. A validated modified Persian version of the Rome III questionnaire was applied for assessment of IBS. @*Results@#Totally, 22.2% of study participants were affected by IBS. After adjustment for potential confounding factors, we found that participants in the highest tertile of DASH score had lower odds of IBS (OR, 0.65; 95% CI, 0.50-0.83) compared with those in the lowest tertile. The same findings were also reached for IBS with constipation (OR for the highest vs the lowest tertile of DASH-style diet = 0.56; 95% CI, 0.38-0.85). No significant association was seen between adherence to DASH-style diet and IBS with diarrhea (OR, 1.31; 95% CI, 0.83-2.06). @*Conclusions@#We found a significant inverse association between adherence to DASH dietary pattern and odds of IBS and IBS with constipation.Further prospective studies are required to confirm these findings.

A one-year hospital-based prospective CVOID-19 open-cohort in the Eastern Mediterranean region: The Khorshid COVID Cohort (KCC) study

The COVID-19 is rapidly scattering worldwide, and the number of cases in the Eastern Mediterranean Region is rising, there is a need for immediate targeted actions. We designed a longitudinal study in a hot outbreak zone to analyze the serial findings between infected patients for detecting temporal changes from February 2020. In a hospital-based open-cohort study, patients are followed from admission until one year from their discharge (the 1st, 4th, 12th weeks, and the first year). The measurements included demographic, socio-economics, symptoms, health service diagnosis and treatment, contact history, and psychological variables. The signs improvement, death, length of stay in hospital were considered as primary, and impaired pulmonary function and psychotic disorders were considered as main secondary outcomes. Notably, In the last two follow-ups, each patient attends the hospital to complete the Patient Health Questionnaire-9 (PHQ-9) and the Depression Anxiety Stress Scales (DASS-21). Moreover, clinical symptoms and respiratory functions are being determined in such follow-ups. Among the first 600 COVID-19 cases, a total of 490 patients with complete information (39% female; the average age of 57{+/-}15 years) were analyzed. Seven percent of these patients died. The three main leading causes of admission were: fever (77%), dry cough (73%), and fatigue (69%). The most prevalent comorbidities between COVID-19 patients were hypertension (35%), diabetes (28%), and ischemic heart disease (14%). The percentage of primary composite endpoints (PCEP), defined as death, the use of mechanical ventilation, or admission to an intensive care unit was 18%. The following comorbidities were significantly different in the positive and negative PCEP groups: acute kidney disease (p=0.008) and diabetes (p=0.026). For signs and symptoms, fatigue (p=0.020) and sore throat (p=0.001) were significantly different. This long-term prospective Cohort may support healthcare professionals in the management of resources following this pandemic.

Risk prison and hepatitis B virus infection among inmates with history of drug injection in Isfahan, Iran.

OBJECTIVES: Hepatitis B virus (HBV) is a health problem among injection drug users (IDUs) in prison. The aim of this study is to evaluate the association of factors of incarceration with HBV infection in prisoners with history of drug injection in Isfahan, Iran. METHODS: In a cross-sectional study, all IDUs inmates were enrolled. Sociodemographic characteristics and associated risk factors were obtained. Blood samples were collected and serological markers for HBV were analyzed. For data analysis, odds ratio and logistic regression were used. RESULTS: Of the IDUs inmates, 970 subjects participated in the study. History of imprisonment (OR: 1.82, 95% CI: 1.28-2.57), multiple incarceration (OR: 1.43, 95% CI: 1.01-2.02), and total duration of imprisonment (OR: 2.70, 95% CI: 1.94-3.74) were significantly associated with prevalence of HBV among IDUs inmates. Multivariate analysis of associated factors showed that only total duration of incarceration is significantly associated with HBV infection. CONCLUSION: In conclusion, according to our results, multiple and duration of incarcerations will be considered as important risk factors of HBV infection in IDUs inmates. This fact makes it important to set some screening and prevention programs in prisons to decrease the risk of being infected and prevent the transmission of these diseases.