title: Feelings of depression in people with ARM: the role of critical incidents and perceived difficulties in close and sexual relationships.
abstract: OBJECTIVE
  Managing a chronic disease may be a difficult task which may lead patients to experience psychological distress and depression. Some studies showed that, in ARM patients, fecal incontinence (FI) is related to symptoms of depression while others studies did not. No studies investigated this relationship in adults. Since fear of having FI episodes, negative feelings associated with these episodes, and difficulties in close and sexual relationships are often reported by patients as important consequences of ARM, we were interested in investigating whether these aspects contribute in explaining feelings of depression.
  
  
  METHODS
  Questionnaires were sent to 160 adult members of the Italian Association for Anorectal Malformation. A new scale measuring the fear of having FI episodes, negative feelings associated with these episodes and difficulties in close/sexual relationship was developed. Depressive feelings and FI were also measured.
  
  
  RESULTS
  Seventy-two adults answered the questionnaires. Regression analyses showed that, in males, depressive feelings were predicted by difficulties in close and sexual relationships (B = 0.46; P < 0.01), while, in females, they were predicted by the fear of having FI episodes (B = 0.53; P < 0.05) and by negative feelings (B = 0.58; P < 0.01).
  
  
  CONCLUSIONS
  Interventions aimed to prevent depression in ARM patients should consider gender and should be targeted on different aspects.
authors.affiliation: Italian Parents and Patients Organization for Anorectal Malformations (AIMAR), Via Tripolitania, 211, 00199, Rome, Italy, caterina.grano@uniroma1.it.
authors.forename: C
authors.initials: C
authors.lastname: Grano
authors.forename: S
authors.initials: S
authors.lastname: Bucci
authors.forename: D
authors.initials: D
authors.lastname: Aminoff
authors.forename: F
authors.initials: F
authors.lastname: Lucidi
authors.forename: C
authors.initials: C
authors.lastname: Violani
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities*; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000209:etiology* / Q000523:psychology; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012007:Rectum / Q000002:abnormalities*; D012189:Retrospective Studies; D012725:Sexual Behavior; D019529:Sexuality; D011795:Surveys and Questionnaires; D055815:Young Adult