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Emotional and behavioural problems in children and adolescents: The role of constipation
Author(s) -
Santos Ivana R,
Abreu Glícia E,
Dourado Eneida R,
Martinelli Braga Ana A N,
Lobo Victoria A,
Carvalho Isabella W B,
Bastos Netto José M,
Barroso Ubirajara
Publication year - 2021
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.15368
Subject(s) - medicine , interquartile range , constipation , confidence interval , strengths and difficulties questionnaire , observational study , pediatrics , cross sectional study , functional constipation , psychiatry , mental health , pathology
Aim The functional constipation (FC) is a source of an expressive suffering in children, negatively affecting their emotional, social, and physical well‐being. The objective of this study is to describe the clinical and behavioural characteristics of children/adolescents with FC. Methods A cross‐sectional, observational, analytical study was conducted in public places by interviewing parents of children/adolescents about their child's bowel habits and psychological profile. Bowel symptoms were investigated using the Rome IV criteria. The Strengths and Difficulties Questionnaire (SDQ) was used to evaluate the emotional and behavioural problems. Results Of 799 children/adolescents included, 424 (53.1%) were female. Mean age was 9.1 ± 2.7 years. FC prevalence was 20.4%. The most common symptoms in Rome IV criteria were ‘painful or hard bowel movements’ ( n = 110; 67.5%; 95% confidence interval: 60.0–74.3) and ‘retentive posturing or excessive volitional stool retention’ ( n = 89; 54.6%; 95% confidence interval: 46.9–62.1). Median scores for internalising symptoms (7; interquartile range (IQR): 4–9 vs. 5; IQR: 2–7; P < 0.001) and externalising symptoms (7; IQR 4–11 vs. 6; IQR 3–9; P < 0.001) were higher in constipated children compared to non‐constipated participants, respectively. The SDQ domains that were associated with FC were emotional symptoms (median 4, P < 0.001) and conduct problems (median 3, P < 0.001). No association was found between faecal incontinence and median scores for the internalising/externalising symptoms. All Rome IV criteria were associated with abnormal overall SDQ scores. Conclusion Children and adolescents with FC had more emotional and behavioural problems irrespective of whether faecal incontinence was present or not, with higher scores for internalising and externalising symptoms compared to non‐constipated children.