Behavioral and emotional problems in adolescents with constipation and their association with quality of life

• Published in: PloS one Vol. 15; no. 10; p. e0239092
• Main Authors: Rajindrajith, Shaman, Ranathunga, Nayomi, Jayawickrama, Nirodha, van Dijk, Marieke, Benninga, Marc A, Devanarayana, Niranga Manjuri
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 12-10-2020; Public Library of Science (PLoS)
• Subjects: Adolescents; Age; Aggressiveness; Anxiety; Behavior; Biology and Life Sciences; Broadband; Children; Children & youth; Complications and side effects; Constipation; Data collection; Elementary school students; Emotional behavior; Fecal incontinence; Health aspects; High school students; Hospitals; Internalization; Irritable bowel syndrome; Medicine and Health Sciences; Parents & parenting; Pediatrics; People and Places; Personality; Physiology; Psychological aspects; Quality of life; Questionnaires; Schools; Social conditions; Social problems; Social Sciences; Surveys; Teenagers; Withdrawal; Sri Lanka; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0239092

Objectives To assess behavioral and emotional problems in children and adolescents with functional constipation and their relationship with psychological maladjustment and health-related quality of life (HRQoL). Design A school-based cross-sectional survey conducted in 8 randomly selected schools from 4 randomly selected districts in Sri Lanka. A previously validated questionnaire was used for data collection. Behavioral and emotional problems were assessed using the Sinhala version of the Child Behavior Check List (CBCL-S/4-18). Constipation was diagnosed by applying the Rome III criteria. Results A total of 1000 questionnaires were distributed, and 913 completed questionnaires were included in the analysis. Sixty adolescents (6.5%) had functional constipation. Scores obtained for isolated psychological problems such as withdrawal (3.1 [3.1] vs. 1.9 [2.4], p<0.001), somatic complaints (3.2 [2.8] vs. 2.3 [2.5], p<0.05) anxiety/depression (5.8 [2.5] vs. 3.9 [3.6], p<0.001), social problems (3.0 [2.7] vs. 2.2 [1.9] p<0.001) and attention problems (5.4 [4.1] vs. 3.9 [3.4], p<0.001), and broadband scale of internalization (12.1 [8.4] vs. 8.3 [7.2], p<0.05) and mean total CBCL-S/4-18 score (29.4 [19.5] vs. 23.2 [17.0], p<0.001) were higher in adolescents with functional constipation. Clinical characteristics, socio-demographic and family factors and psychological maladjustment had no relationship with externalization, internalization and total CBCL-S/4-18 score. Internalization (-0.49, p<0.0001), externalization (-0.30, p<0.05), and total CBCL-S/4-18 (-0.44, p<0.001) scores had a negative impact on HRQoL of adolescents with functional constipation. Conclusions Adolescents with functional constipation are suffering from significant behavioral and emotional problems. These problems negatively affect their HRQoL.