Exploration of cross-sectional associations between constipation and anticholinergic burden of psychotropic treatments in adults with bipolar disorders.

Constipation is a frequent adverse effect of psychotropic medications with anticholinergic properties and may lead to significant discomfort, reduced adherence, and serious medical complications. In adults with bipolar disorder, psychotropic polypharmacy and exposure to anticholinergic drugs are common, yet the digestive safety of these treatments remains insufficiently characterized. This cross-sectional observational study aims to examine the association between anticholinergic burden and constipation in adults with bipolar disorders using baseline data from the FACE-BD cohort. By comparing multiple validated anticholinergic burden scales, the study seeks to identify which measures are most strongly associated with constipation and whether these associations persist after accounting for relevant demographic, clinical, biological, and lifestyle factors. Secondary objectives include exploring the relationship between constipation, medication adherence, and quality of life. By identifying the most clinically informative measures of anticholinergic burden, this study aims to improve the identification of patients at higher risk of constipation and to inform future research and clinical strategies focused on the digestive safety of psychotropic treatments in bipolar disorder.