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. 2019 Dec;17(13):2696-2703.
doi: 10.1016/j.cgh.2019.03.046. Epub 2019 Apr 4.

Chronic Diarrhea and Constipation Are More Common in Depressed Individuals

Sarah Ballou  1 , Jesse Katon  2 , Prashant Singh  2 , Vikram Rangan  2 , Ha Neul Lee  2 , Courtney McMahon  2 , Johanna Iturrino  2 , Anthony Lembo  2 , Judy Nee  2
Affiliations

Chronic Diarrhea and Constipation Are More Common in Depressed Individuals

Sarah Ballou et al. Clin Gastroenterol Hepatol. 2019 Dec.

Abstract

Background and aims: Depression is a major health issue in the United States and is highly comorbid with gastrointestinal conditions. We collected data from the National Health and Nutrition Examination Survey (NHANES), a representative sample of the US population, to study the relationship between depression and bowel habits.

Methods: Using data from the NHANES (2009-2010), we identified 495 depressed and 4709 non-depressed adults who filled out the Bowel Health Questionnaire. Depression was defined according to a validated questionnaire. We used multivariable analysis, controlling for clinical and demographic variables, to evaluate the relationship between mood and bowel habits.

Results: In our weighed sample, 24.6% of depressed individuals and 12.6% of non-depressed individuals reported disordered bowel habits. Chronic diarrhea was significantly more prevalent in depressed individuals (15.53%; 95% CI, 11.34%-20.90%) than non-depressed individuals (6.05%; 95% CI, 5.24%-6.98%; P = .0001). Chronic constipation was also more common in depressed individuals (9.10%; 95% CI, 7.02%-11.69%) than non-depressed individuals (6.55%; 95% CI, 5.55%-7.70% CI; P = .003). Mean depression scores in patients with chronic diarrhea (4.9 ± 5.8) and with chronic constipation (4.4 ± 4.93) were significantly higher than mean depression scores for individuals with normal bowel habits (3.2 ± 4.6) (P < .001). Moderate and severe depression were significantly associated with chronic diarrhea but not chronic constipation. Only mild depression was significantly associated with chronic constipation.

Conclusions: In an analysis of the NHANES database, we found a higher proportion of depressed individuals to have chronic diarrhea and constipation than non-depressed individuals; chronic diarrhea was more strongly associated with depression. Our findings provide support for the relationship between mood and specific bowel habits, accounting for multiple co-variables in a large sample of the general US population.

Keywords: GI; IBD; IBS; Irritable Bowel Syndrome; Psychology.

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Figures

Figure 1.
Figure 1.
Percentages of depressed and non-depressed individuals with chronic constipation, normal bowel habits, and chronic diarrhea.
Figure 2.
Figure 2.
Weighed percentage of population with (A) chronic diarrhea according to depression severity (B) chronic constipation according to depression severity and (C) normal bowel habits according to depression severity
Figure 2.
Figure 2.
Weighed percentage of population with (A) chronic diarrhea according to depression severity (B) chronic constipation according to depression severity and (C) normal bowel habits according to depression severity
See this image and copyright information in PMC

Comment in

  • Association Between Depression and Chronic Gastrointestinal Symptoms.
    Oungpasuk K, Li YM, Stettler I. Oungpasuk K, et al. Clin Gastroenterol Hepatol. 2020 Jul;18(8):1898. doi: 10.1016/j.cgh.2019.12.042. Epub 2020 Jan 15. Clin Gastroenterol Hepatol. 2020. PMID: 31954201 No abstract available.
  • Reply.
    Ballou S. Ballou S. Clin Gastroenterol Hepatol. 2020 Jul;18(8):1899. doi: 10.1016/j.cgh.2020.02.024. Epub 2020 Feb 20. Clin Gastroenterol Hepatol. 2020. PMID: 32088304 No abstract available.

References

    1. Mykletun A, Jacka F, Williams L, et al. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC Gastroenterol 2010;10:88. - PMC - PubMed
    1. Fuller-Thomson E, Sulman J. Depression and inflammatory bowel disease: findings from two nationally representative Canadian surveys. Inflamm Bowel Dis 2006;12:697–707. - PubMed
    1. Bhandari S, Larson ME, Kumar N, et al. Association of Inflammatory Bowel Disease (IBD) with Depressive Symptoms in the United States Population and Independent Predictors of Depressive Symptoms in an IBD Population: A NHANES Study. Gut Liver 2017;11:512–519. - PMC - PubMed
    1. Singh P, Agnihotri A, Pathak MK, et al. Psychiatric, somatic and other functional gastrointestinal disorders in patients with irritable bowel syndrome at a tertiary care center. J Neurogastroenterol Motil 2012;18:324–331. - PMC - PubMed
    1. Vandvik PO, Wilhelmsen I, Ihlebaek C, et al. Comorbidity of irritable bowel syndrome in general practice: a striking feature with clinical implications. Aliment Pharmacol Ther 2004;20:1195–1203. - PubMed

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