Relationship Between Depression and Constipation: A Cross-Sectional Health Report From the PERSIAN Guilan Cohort...

The interaction between psychological factors and gastrointestinal function has been widely recognized, with particular attention given to how stress and anxiety can significantly influence digestive processes and bowel activity. This study evaluated the association between depression and constipation in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort Study (PGCS) population.

This cross-sectional study has been conducted on recorded data of 10520 participants aged 35-70 years. Demographic, lifestyle, and medical history data were collected through in-person interviews and standardized questionnaires. Variables included age, sex, education, wealth index, tobacco and substance use, dietary habits, chronic disease history, and medication use. Depression was identified based on self-reported physician diagnosis or current antidepressant use. Chronic constipation was defined as fewer than three bowel movements per week, assessed via questions on bowel habits, bloating, and laxative use, consistent with Mayo Clinic criteria. Data was analyzed using SPSS version 16.0 and level of significance was set at 0.05.

Among 10520 participants (mean age 51.52 ± 8.90 years; 53.5% female), the prevalence of depression and constipation was 5.22% and 4.45%, respectively. Depression was more common in females than males (7.33% vs. 2.78%, p < 0.001), while constipation was also more frequent in females (6.00% vs. 2.66%, p < 0.001) and increased with age (p < 0.001). Constipation was significantly more prevalent in those with depression (10.20% vs. 4.13%, p < 0.001), with a stronger association observed in males. Logistic regression showed that depression increased the odds of constipation (unadjusted OR = 2.64; adjusted OR = 1.92, 95% CI: 1.41-2.60), with a higher effect size in men across all models.

These findings demonstrated that depression was significantly associated with higher odds of constipation, particularly among males, highlighting the need for integrated mental and gastrointestinal health assessments.