title: Patients with irritable bowel syndrome and constipation are more depressed than patients with functional constipation.
abstract: BACKGROUND
  Psychosocial factors, such as depression, have been shown to be associated with gastrointestinal disorders like constipation.
  
  
  METHODS
  We retrospectively compared the depression and anxiety profiles of patients with irritable bowel syndrome with constipation versus those of patients with functional constipation using validated questionnaires. Subjects rated the intensity of digestive symptoms experienced during the previous month using visual analogue scales. Colonic transit time measurements and anorectal manometry were performed.
  
  
  RESULTS
  Of the 128 consecutive, constipated patients included (84% females, mean age 49.7 ± 15.5 years) 66 suffered from irritable bowel syndrome with constipation and 62 from functional constipation. Demographic and physiological traits were similar in the two groups. Patients suffering from irritable bowel syndrome with constipation reported higher depression scores (18.8 ± 1.4 vs 12.7 ± 1.3, P=0.002) and higher symptom intensity scores for constipation (6.2 ± 0.3 vs 4.3 ± 0.4, P<0.001), bloating (6.7 ± 0.3 vs 3.3 ± 0.4, P<0.001) and abdominal pain (6.0 ± 0.3 vs 2.7 ± 0.4, P<0.001) than patients with functional constipation. Multiple linear regression showed positive correlations between symptom intensity and depression and anxiety scores for functionally constipated patients only.
  
  
  CONCLUSIONS
  Our results support the integration of a psychosocial component to the traditional treatment of constipated patients; however, further research exploring causality between psychosocial factors and specific gastrointestinal disorders would contribute to developing a tailored therapeutic approach.
authors.affiliation: University of Praris V René Descartes 15, Paris, France; Gastroenterology Unit, Avicenne Hospital, BOBIGNY Cedex, France. Electronic address: michel.bouchoucha@avc.aphp.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Bouchoucha
authors.affiliation: Gastroenterology Unit, Avicenne Hospital, BOBIGNY Cedex, France.
authors.forename: Maria
authors.initials: M
authors.lastname: Hejnar
authors.affiliation: Surgery Department, Sherbrooke University, Quebec, Canada.
authors.forename: Ghislain
authors.initials: G
authors.lastname: Devroede
authors.affiliation: Clinical Research Unit, Avicenne Hospital, BOBIGNY Cedex, France.
authors.forename: Marouane
authors.initials: M
authors.lastname: Boubaya
authors.affiliation: Gastroenterology Unit, Avicenne Hospital, BOBIGNY Cedex, France.
authors.forename: Cyriaque
authors.initials: C
authors.lastname: Bon
authors.affiliation: Gastroenterology Unit, Avicenne Hospital, BOBIGNY Cedex, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Benamouzig
mesh_terms: D015746:Abdominal Pain / Q000523:psychology; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D003248:Constipation / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000523:psychology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000523:psychology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Ano-rectal manometry; Anxiety; Colonic transit time; Constipation; Depression; IBS-constipation