Depression strongly predicts absenteeism among patients with chronic constipation
Absenteeism among patients with chronic constipation appear to have a stronger association with depression than symptom severity, according to a recent study, suggesting that a portion of the indirect costs of chronic constipation is attributable to depression.
Researchers examined 148 consecutive patients with chronic constipation (mean age 43 years; 87 percent female) to determine the patient characteristics associated with increased absenteeism and Emergency Department (ED) utilization.
Disease severity, quality of life, somatization and psychiatric comorbidities were assessed using standardized instruments. Multivariable logistic regression facilitated identification of the predictors of work and school absenteeism, as well as ED visits for constipation.
Of the patients, 21.6 percent had high absenteeism, and 24.3 percent visited the ED for constipation in the past year. Chronically constipated patients with high absenteeism and ED visits were more likely to be depressed (56.3 vs 18.5 percent for high absenteeism; p<0.0001; 47.2 vs 19.6 for ED visits; p<0.01).
On analyses, depression was associated with a 4.41-fold increase in the risk of absenteeism (p<0.01). Additionally, a trend toward an association between depression and ED visits (OR, 2.57; p=0.067) was observed.
There was no association between symptom severity and high absenteeism or ED utilization.
The present data suggest that depression, but not symptom severity, strongly predicts absenteeism among patients with chronic constipation.