Children and adolescents with constipation: Do they have different personalities?

Abstract

BACKGROUND AND AIMS: Children with constipation are known to have behavioral and psychological problems. This may partly be due to difference in their personality. Aim of this study is to assess the different personality traits in children having functional constipation. METHOD: We conducted a cross sectional survey in 5 schools in the Eastern province of Sri Lanka. Children and adolescents between 13–18 years were included in the study. Previously validated questionnaires were used to collect bowel habits and demographic data. Translated and validated personality assessment questionnaire (PAQ) was used to assess the personality. Rome III criteria were used to diagnose constipation. RESULTS AND DISCUSSION: A total of 1697 children were recruited [males 778 (45.9%), mean age 15.1 years and SD 1.66 years]. Prevalence of constipation was 6% (102 children). They were compared with 1018 normal children (controls). Seventy eight (76.5%) children with constipation and 426 (41.8%) of controls had PAQ scores above the normative value for Sri Lankan children (89) (p <0.0001). When the international normative value of 105 was used, 33 (32.4%) children with constipation and 111 (10.8%) of controls had psychological maladjustment (p < 0.001). Furthermore Children with constipation scored significant higher scores for different personality traits than controls. They include hostility and aggression (14.1 vs. 12.1 in controls p < 0.001), negative self esteem (11.7 vs. 10.2 in controls p < 0.001), negative self adequacy (11.7 vs. 9.5 controls p < 0.001), emotional unresponsiveness (12.7 vs. 11.1 controls p < 0.001), emotional instability (17.3 vs. 15.0 p < 0.001), and negative world view (12.1 vs. 9.9 controls p < 0.001). CONCLUSIONS: Children with constipation have significant psychological maladjustment than healthy controls. This maladjustment was prominent in hostility and aggression, negative self esteem, negative self adequacy, emotional unresponsiveness, emotional instability and negative world view domains. Addressing these issues is important in the management of children with constipation.