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. 2025 Feb;55(2):585-591.
doi: 10.1007/s10803-023-06228-8. Epub 2024 Jan 24.

Psychiatric Features of Children with Chronic Functional Constipation: Focusing on Individuals with Autism Spectrum Disorder

Fumiaki Akama  1 , Katsunaka Mikami  2 , Yasushi Orihashi  3 , Syunya Takase  1 , Kyuta Hanawa  1 , Keita Nishikawa  1 , Natsuru Watanabe  1 , Keitaro Kimoto  1 , Yuki Takahashi  1 , Yuichi Onishi  1 , Juan Salas  4 , Kenji Yamamoto  1 , Shigeru Ueno  5   6
Affiliations

Psychiatric Features of Children with Chronic Functional Constipation: Focusing on Individuals with Autism Spectrum Disorder

Fumiaki Akama et al. J Autism Dev Disord. 2025 Feb.

Abstract

Purpose: The present study aimed to assess the psychiatric characteristics of children with chronic functional constipation using the Aberrant Behavior Checklist-Japanese version and the Pervasive Developmental Disorders/Autism Society Japan Rating Scale, and to examine the frequency of autism spectrum disorder in children with chronic functional constipation. We also investigated differences in treatment duration between children with and without autism spectrum disorder.

Methods: Treatment outcomes were examined retrospectively for 55 participants (chronic functional constipation group: n = 30, mean age 3.4 years; control group: n = 25, mean age, 4.5 years). The association between chronic functional constipation and autism spectrum disorder was evaluated using multivariable logistic regression analysis.

Results: The mean Aberrant Behavior Checklist score and frequency of individuals with autism spectrum disorder were significantly higher in the chronic functional constipation group. After adjusting for age and sex, chronic functional constipation was significantly associated with autism spectrum disorder. In the chronic functional constipation group, the frequency of onset was significantly higher in children with autism spectrum disorder under 1 year of age. When treated, the mean duration of constipation was significantly longer in children with autism spectrum disorder.

Conclusion: Pediatricians, pediatric surgeons, and child psychiatrists should work closely to ensure appropriate treatment of chronic functional constipation in children with autism spectrum disorder.

Keywords: Abnormal Behavior; Autism Spectrum Disorder; Children; Chronic Functional Constipation; Infants.

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Conflict of interest statement

Declarations. Declarations of Conflicting Interests: Fumiaki Akama has received a Grant-in-Aid for Scientific Research (C) (Number 21K11372) and financial support from Otsuka Pharmaceutical and Shionogi & Co. and honoraria from Eisai Co, Pfizer, Shionogi & Co., and Sumitomo Pharma. Katsunaka Mikami has received a Grant-in-Aid for Scientific Research (C) (Number 22K07624) and financial support from Otsuka Pharmaceutical Co., Ltd., and Shionogi & Co., Ltd.; honoraria from Otsuka Pharmaceutical Co., Ltd., Shionogi & Co., Ltd., Sumitomo Pharma Co., Ltd., and Takeda Pharmaceutical Co., Ltd.; travel expenses for the spouse from Pfizer; and a consulting fee from Otsuka Pharmaceutical Co., Ltd., Shionogi & Co., Ltd., and Viatris. Yasushi Orihashi received consulting fees from the Association of Medical Education and Ethics, Kitasato Clinical Research Center, and Daiichi Sankyo Co. Natsuru Watanabe received Grant-in-Aid for Early-Career Scientists (Number 19K17072). Keitaro Kimoto reports grants and personal fees from Otsuka Pharmaceutical Co., Ltd., and Shionogi & Co., Ltd, honoraria from Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharma Co., Ltd, and Viatris. Yuki Takahashi reports grants and personal fees from Shionogi & Co. Yuichi Onishi has received honoraria from Takeda Pharma Co., Ltd. Kenji Yamamoto reports grants and personal fees from Eisai Co., Ltd., grants and personal fees from Otsuka Pharmaceutical Co., Ltd., personal fees from Meiji Seika Pharma Co., Ltd., personal fees from Sumitomo Dainippon Pharma Co., Ltd., personal fees from Pfizer Japan Inc., personal fees from Mitsubishi Tanabe Pharma Corporation, personal fees from Shionogi & Co., Ltd, personal fees from Eli Lilly and Company, personal fees from EA Pharma Co., Ltd., personal fees from Merck Sharp & Dohme, personal fees from Viatris Inc., personal fees from Astellas Pharma Co., Ltd., personal fees from Shionogi & Co., Ltd., personal fees from Takeda Pharma Co., Ltd., grants from Grants-in-Aid for Scientific Research (C), outside the submitted work. Syunya Takase, Kyuta Hanawa, Keita Nishikawa, Juan Salas, and Shigeru Ueno had no conflict of interest. Ethical Approval: This research consisted of two clinical studies. The first cross-sectional study was approved by the Institutional Review Board for Clinical Research at Tokai University School of Medicine (ref, #13R-106). The next follow-up study was also approved by the Institutional Review Board for Clinical Research at Tokai University School of Medicine (ref, # 20R-394). Consent to Participate: While we planned to obtain written consent from children ≥ 12 years, the maximum age of the participants was 10 years; therefore, written consent was obtained from guardians. Consent to Publish: Not Applicable.

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