Objectives To assess psychological maladjustment in adolescents with functional constipation.
Study design We conducted a cross-sectional survey in five schools. Adolescents aged between 13 and 18 years were included in the study. Validated questionnaires were used to collect bowel habits and demographic data, health-related quality of life (HRQoL) and psychological maladjustment. Rome III criteria were used to diagnose constipation.
Results 1697 adolescents were recruited (boys 779 (45.9%), mean age 15.06 years and SD 1.6 years). Prevalence of constipation was 6.7%, of whom 52 were boys (45.6%) and 62 were girls (54.4%). 38 adolescents (33.3%) with constipation and 230 controls (14.5%) had significant psychological maladjustment. Among seven different personality dimensions used to assess psychological maladjustment, children with constipation had significantly more deficits than controls in hostility and aggression (14.2 vs 12.6 in controls (mean difference 1.54, 95% CI (0.89 to 2.19) p<0.001), negative self-esteem (12.0 vs 10.5 in controls, mean difference 1.54 95% CI (0.96 to 2.06) p<0.001), negative self-adequacy (11.9 vs 9.8 controls, mean difference 2.07 95% CI (1.46 to 2.67) p<0.001), emotional unresponsiveness (12.9 vs 11.5 controls, mean difference 1.44 95% CI (0.84 to 2.04) p<0.001), emotional instability (17.1 vs 15.6, mean difference 1.53 95% CI (0.86 to 2.2) p<0.001) and negative world view (12.1 vs 10.2 controls, mean difference 1.91 95% CI (1.24 to 2.59) p<0.001). The total HRQoL of adolescents with constipation was lower than controls (70.6 vs 79.0 mean difference 9.48 95% CI (1.4 to 6.7) p<0.05).
Conclusion A significant proportion of children with constipation are suffering from psychological maladjustment.
- Adolescent Health
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Contributors NR helped in designing the study, in data collection, made significant contribution to draft the initial manuscript and approved the final manuscript. SR conceptualised the study, helped in designing the study, drafted the initial manuscript and approved the final manuscript. NMD helped in designing the study, in data analysis and approved the final manuscript. MAB contributed with interpretation of data, with significant intellectual input for the manuscript, critically revised the manuscript and approved the final manuscript. MvD helped in interpreting the data, with significant intellectual input for the manuscript and approved the final manuscript.
Funding The work was carried out with personal funding from the first author, Dr Ranasinghe.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Ethics approval Ethical Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka.
Provenance and peer review Not commissioned; externally peer reviewed.