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Fecal incontinence was associated with depression of any severity: insights from a large cross-sectional study

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Abstract

Objective

Current studies on the association between fecal incontinence (FI) and depression are very limited, and most of them are restricted to women or elderly patients. This study aims to evaluate in detail the association between FI and depression among US adults.

Methods

13,480 adults aged 20 years and older were selected from the National Health and Nutrition Examination Survey 2005–2010. Monthly loss of solid, liquid, or mucous stool was defined as FI. Clinical depression and depression severity were assessed by the validated Patient Health Questionnaide-9 (PHQ-9). Models of multivariate logistic regression were used to calculate adjusted odds ratios (ORs). A subgroup analysis was carried out to ensure that the results were stable.

Results

After adjusting for covariates such as demographics, risk behaviors and associated comorbidities, the PHQ-9 score and clinical depression were both significantly associated with FI, with ORs and 95%CIs of 1.11 (1.10–1.13) and 3.01 (2.53–3.57). Depression of all severities was also significantly associated with FI. The ORs and 95%CIs of FI with mild depression, moderate depression, and moderately severe to severe depression were 2.29 (1.96–2.68), 3.44 (2.77–4.27) and 4.65 (3.61–6.00), respectively. Subgroup analyses showed no statistically significant interactions (P > 0.05).

Conclusions

In conclusion, FI significantly associated with depression of any severity. Like the elderly or female patients with FI, young and middle-aged or men with FI are also at high risk of depression and should also be the focus of depression screening and early intervention.

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Data Availability

Publicly available and de-identified data used in this analysis can be found in the CDC National Center for Health Statistics NHANES database at https://wwwn.cdc.gov/nchs/nhanes/Default.as px.

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Acknowledgements

We thank Dr. Liu Jie (People’s Liberation Army of China General Hospital, Beijing, China) and Dr. Yang Qilin (The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou, Guangdong, China) for helping in this revision.

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Authors and Affiliations

  1. Department of Oncology, China Academy of Chinese Medical Sciences Guang’ anmen Hospital, 100053, Beijing, China

    Yan Wang

  2. Department of Anesthesiology, Hekou District People’s Hospital, 257200, Dongying City, Shandong Province, China

    Na Li

  3. Department of Orthopedic Surgery, Hekou District People’s Hospital, 257200, Dongying City, Shandong Province, China

    Qiang Zhou

  4. Department of Anorectal surgery, China Academy of Chinese Medical Sciences Xiyuan Hospital, 100091, Beijing, China

    Pengfei Wang

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  1. Yan Wang
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Contributions

P.W., Y.W., N.L. and Q.Z. designed, performed and analyzed the study. P.W. and Y.W. wrote the first draft of the article. N.L. and Q.Z. helped design and analyze the study. All authors contributed to writing and discussing the article.

Corresponding author

Correspondence to Pengfei Wang.

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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethics statement

Institutional Research Ethics Review Board of the CDC approved the protocol for the NHANES survey. The protocol was approved by the NCHS Ethics Review Board with informed consent from all participants.

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Wang, Y., Li, N., Zhou, Q. et al. Fecal incontinence was associated with depression of any severity: insights from a large cross-sectional study. Int J Colorectal Dis 38, 271 (2023). https://doi.org/10.1007/s00384-023-04563-x

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