Prevalence and risk factors of constipation among psychiatric outpatients: A cross-sectional study.

OBJECTIVE

To determine the prevalence of constipation among psychiatric outpatients and identify associated risk factors.

METHODS

A cross-sectional survey was conducted at our hospital from February to April 2025. Psychiatric outpatients (N = 2971) were invited to complete an online questionnaire assessing constipation via Rome IV criteria, the Bristol Stool Form Scale (BSFS), and self-reported constipation. Symptom severity and quality of life were measured using the PAC-SYM and PAC-QOL scales. Data analysis included Spearman correlation and multivariate logistic regression.

RESULTS

Among 1045 valid respondents (52.0% effective response rate), constipation prevalence was 21.63% (Rome IV), 34.74% (BSFS), and 29.28% (self-report). For Rome IV-defined constipation, risk factors included history of comorbidity (OR = 1.66; 95% CI: 1.17-2.36), depression disorder (OR = 1.61; 95% CI: 1.17-2.22), and history of lactulose (OR = 2.76; 95% CI: 1.87-4.09) or glycerin enema (OR = 3.04; 95% CI: 1.94-4.76; all P < 0.01). In the Bristol model, risk factors included schizophrenia (OR = 2.12), and history of lactulose (OR = 1.72) or enemas (OR = 1.84). For self-reported constipation, risk factors included female (OR = 1.79), depression disorder (OR = 1.56), and history of lactulose (OR = 3.03) or enemas(OR = 3.73) (all P < 0.01). Constipated patients had higher symptom severity (PAC-SYM: 7.0-11.5 vs. 2.0-3.0) and worse quality of life (PAC-QOL: 19.0-31.0 vs. 11.0-15.0; P < 0.001).

CONCLUSIONS

Constipation is prevalent among psychiatric outpatients and is associated with specific demographic and clinical factors. Targeted screening and management focusing on laxative use and psychiatric diagnoses may improve patient outcomes.