Impact of constipation on patients with schizophrenia and depression: an internet-based survey (CONSIDER survey)

Constipation, a common gastrointestinal disorder, impairs quality of life (QOL) and work productivity. This study evaluated constipation severity in individuals with schizophrenia, depression, and the general population and examined its impact on QOL and work productivity, as well as patient education and preferences regarding constipation management.

A cross-sectional web-based survey was conducted. Assessments included the Constipation Scoring System (CSS), Short Form-8, Work Productivity and Activity Impairment questionnaire, and questions regarding prior explanations of constipation risk and changes in bowel habits. CSS scores were stratified as ≤5 and ≥6.

In total, 800 participants completed the survey (schizophrenia, n=200; depression, n=200; general population, n=400). CSS scores were higher in the schizophrenia and depression groups than in the general population. Multivariable regression analysis showed that schizophrenia and depression were associated with constipation severity. In the schizophrenia and depression groups, current symptom status and anxiolytic use remained independently associated with CSS scores. Across all groups, participants with CSS scores ≥6 had lower Mental Component Summary scores and higher levels of presenteeism, overall work productivity loss, and activity impairment than those with CSS scores ≤5. Approximately 30% of all participants in each of the schizophrenia and depression groups reported receiving prior explanations regarding psychotropic-related constipation risk, while 40% reported bowel-habit changes after psychotropic drug initiation.

Constipation severity was higher in participants with schizophrenia and depression than in the general population; greater severity was associated with lower QOL and greater work productivity impairment. Routine screening, education on constipation, and patient-centered constipation management may be useful clinical approaches for addressing constipation and its associated burden in these populations.

This study was registered with the University Hospital Medical Information Network (UMIN000058981).