Analysis of Factors Related to Constipation in Hospitalised Patients with Schizophrenia: A Study from Wuhan, China

Ji-Fen Gong,1,2,* Chun-Xi Wu,2,* Juan Qiao,2,* Li-Hua Li,3 Shi-Qiang Xiang,1 Yi Liu,2 Hai-Bo Zheng,2 Ming-Chao Li,4 Zi-Jun Xiong,5 Xiao-Jun Wang,2 Qiu-Ming Ji6 1School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, 430075, People’s Republic of China; 2Department of Psychiatry, Wuhan Wudong Hospital, Wuhan, Hubei, 430084, People’s Republic of China; 3Department of Finance, Wuhan Wudong Hospital, Wuhan, Hubei, 430084, People’s Republic of China; 4Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, 430022, People’s Republic of China; 5Department of Laboratory, Wuhan Wudong Hospital, Wuhan, Hubei, 430084, People’s Republic of China; 6Department of Science, Wuhan Wudong Hospital, Wuhan, Hubei, 430084, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shi-Qiang Xiang, School of Public Health, Wuhan University of Science and Technology, 947 Heping Avenue, Qingshan District, Wuhan, Hubei, 430075, People’s Republic of China, Email xiangshiqiang3868@126.com Xiao-Jun Wang, Department of Psychiatry, Wuhan Wudong Hospital, No. 46, Ankang Lane, Wudong Street, Qingshan District, Wuhan, Hubei, 430084, People’s Republic of China, Tel +86 27 5052 8367, Fax +86 27 8643 8247, Email xiaoju.nwang@outlook.comObjective: To investigate the factors associated with constipation in patients with schizophrenia.Methods: This retrospective study analysed medical records of hospitalised patients with schizophrenia admitted to a psychiatric department in Wuhan between January and December 2023. Demographic and clinical data were collected and cross-checked by psychiatrists. Logistic regression analysis was used to identify independent risk factors.Results: Among 904 patients, 268 (29.65%) had constipation, including incomplete intestinal obstruction (5.97%), anal fissures (20.89%) and haemorrhoids (38.10%). The prevalence was higher in women (33.59%) than in men (26.73%). Multivariate logistic regression identified poverty (odds ratio [OR] = 1.60, 95% CI: 1.14– 2.23, P = 0.006), disease duration ≥ 10 years (OR = 4.13, 95% CI: 2.41– 7.07, P < 0.001), clozapine use (OR = 2.56, 95% CI: 1.67– 3.94, P < 0.001), combined drug therapy (OR = 2.58, 95% CI: 1.67– 3.99, P < 0.001), comorbid anxiety disorders (OR = 2.64, 95% CI: 1.79– 3.88, P < 0.001), comorbid hypertension (OR = 3.84, 95% CI: 2.73– 5.39, P < 0.001), dyslipidaemia (OR = 1.81, 95% CI: 1.21– 2.71, P = 0.004) and smoking (OR = 1.57, 95% CI: 1.13– 2.20, P = 0.008) as independent risk factors. Subgroup analyses showed stronger associations between clozapine and constipation in women and between long disease duration and constipation in older patients.Conclusion: The prevalence of constipation in patients with schizophrenia is high. For high-risk groups with the above factors, early intervention should be implemented to prevent the onset of constipation and improve patients’ quality of life.Keywords: schizophrenia, constipation, risk factors, psychotropic drugs, anxiety disorders