Depression tied to work, school absenteeism in patients with chronic constipation
Depression appears to be a stronger predictor of absenteeism than symptom severity in patients with chronic constipation, suggests a study, adding that depression may partly contribute to the indirect costs of chronic constipation.
Of the 148 consecutive patients (mean age 43 years; 87 percent female) enrolled in the study, 32 (21.6 percent) had high absenteeism and 36 (24.3 percent) visited the emergency department (ED) for constipation in the past year. Depression was likely in patients with high absenteeism (56.3 percent vs 18.5 percent; p<0.0001) and ED visits (47.2 percent vs 19.6 percent; p<0.01).
Multivariable adjustment and sensitivity analyses revealed that only depression (odds ratio [OR], 4.41; p<0.01) correlated with increased absenteeism, while a trend toward an association between depression and ED visits (OR, 2.57; p=0.067) was observed. In addition, no association was observed between symptom severity and high absenteeism or ED utilization.
The investigators carried out a cross-sectional cohort study of patients with chronic constipation who presented to a tertiary care centre for anorectal manometry to determine patient characteristics related to increased absenteeism and ED utilization.
Standardized instruments were used to evaluate disease severity, quality of life, somatization and psychiatric comorbidities. Multivariable logistic regression was used to determine the predictors of work and school absenteeism as well as ED visits for constipation.
“Chronic constipation is associated with significant direct and indirect economic costs,” the investigators said. “There has been limited study of the predictors of direct and indirect costs in a population with refractory constipation.”