title: Clinical, psychological and maternal characteristics in early functional constipation.
abstract: BACKGROUND
  This cross-sectional study investigated the clinical features of functional constipation (FC) at preschool age, as well as emotional and behavioral characteristics of the children, psychological symptom level and parental attitudes of the mothers, and compared these with that of non-referred typically developing controls with normal intestinal habits.
  
  
  METHODS
  Participants included 65 children with FC (mean age, 43.6 ± 15.4 months; range, 25-72 months), 59 healthy controls (mean age, 46.9 ± 14.5 months; range, 25-72 months) and the mothers of the children. The Childhood Behavior Checklist, Symptom Checklist 90 and Parental Attitude Research Instrument were filled in by the mothers.
  
  
  RESULTS
  Participants with FC had higher problem scores than the comparison children in a variety of emotional and behavioral parameters. Approximately half exhibited internalizing and one-third had externalizing problems in the clinical range. The mothers of the patient group had higher levels of psychological distress, overprotective parenting and strict discipline. On multiple logistic regression analysis child psychopathology, maternal education level and maternal distress were independently associated with FC.
  
  
  CONCLUSIONS
  Behavior problems are common in children with FC from an early age. Low level of education and high psychological distress of the mothers seem to be important risk factors for constipation and should be assessed carefully in the management of these cases.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Kilincaslan
authors.forename: Osman
authors.initials: O
authors.lastname: Abali
authors.forename: Sevcan Karakoc
authors.initials: SK
authors.lastname: Demirkaya
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bilici
mesh_terms: D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003248:Constipation / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology; D016487:Parenting
keywords: functional constipation; maternal distress; parenting attitudes; preschool children; psychological problems