Complaints of constipation in obsessive-compulsive disorder

Area of Science:

• Psychiatry
• Gastroenterology
• Epidemiology

Background:

• Psychoanalytic theory historically links constipation with obsessive-compulsive traits.
• Empirical evidence for this association has been lacking.
• This study investigates the relationship in a large population sample.

Purpose of the Study:

• To empirically test the hypothesized association between medically unexplained constipation and obsessive-compulsive disorder (OCD).
• To examine potential gender differences in this association.
• To determine the specificity of the association to constipation versus other functional bowel symptoms.

Main Methods:

• Analysis of data from the large, randomly sampled Epidemiologic Catchment Area project.
• Utilized the Diagnostic Interview Schedule (DIS) to ascertain constipation and diagnoses.
• Controlled for symptom-reporting biases using somatization disorder symptom counts.

Main Results:

• A significant association was found between constipation and a lifetime diagnosis of obsessive-compulsive disorder (OCD) in women, but not in men.
• This association was specific to constipation and did not extend to other functional bowel symptoms like diarrhea, bloating, or abdominal pain.
• Constipation was not significantly associated with major depression or panic disorder, even after controlling for other somatoform symptoms.

Conclusions:

• The findings partially support a special relationship between OCD and constipation, but only in women, challenging historical psychoanalytic concepts.
• The gender-specific nature of the association warrants further investigation in clinical and research settings.
• This study highlights the importance of considering gender in the investigation of functional bowel symptoms and psychiatric comorbidities.