Latent profile analysis reveals the central role of psychological symptoms in driving disease severity in chronic constipation.

Autor: Abber SR; Department of Psychology, Florida State University, Tallahassee, Florida, USA., Buchanan KL; Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA., Clukey J; Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA., Joiner TE; Department of Psychology, Florida State University, Tallahassee, Florida, USA., Staller K; Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., Burton-Murray H; Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Neurogastroenterology and motility [Neurogastroenterol Motil] 2024 May; Vol. 36 (5), pp. e14773. Date of Electronic Publication: 2024 Feb 23.
DOI: 10.1111/nmo.14773
Abstrakt: Background: Chronic constipation (CC) is defined by symptom criteria reflecting heterogenous physiology. However, many patients with CC have significant psychological comorbidities-an alternative definition using a biopsychosocial classification model could be warranted to inform future treatments. We sought to: (1) empirically derive psychological symptom profiles of patients with CC using latent profile analysis and (2) validate these profiles by comparing them on symptom severity, GI-specific anxiety, body mass index (BMI), and anorectal manometry findings.
Methods: Participants included adults presenting for anorectal manometry for CC (N = 468, 82% female, M age  = 47). Depression/anxiety symptoms and eating disorder (ED) symptoms (EAT-26) were used as indicators (i.e., variables used to derive profiles) representing unique psychological constructs. Constipation symptoms, GI-specific anxiety, BMI, and anorectal manometry results were used as validators (i.e., variables used to examine the clinical utility of the resulting profiles).
Key Results: A 5-profile solution provided the best statistical fit, comprising the following latent profiles (LPs): LP1 termed "high dieting, low bulimia;" LP2 termed "high ED symptoms;" LP3 termed "moderate ED symptoms;" LP4 termed "high anxiety and depression, low ED symptoms;" and LP5 termed "low psychological symptoms." The low psychological symptom profile (61% of the sample) had lower abdominal and overall constipation severity and lower GI-specific anxiety compared to the four profiles characterized by higher psychological symptoms (of any type). Profiles did not significantly differ on BMI or anorectal manometry results.
Conclusions and Inferences: Profiles with high psychological symptoms had increased constipation symptom severity and GI-specific anxiety in adults with CC. Future research should test whether these profiles predict differential treatment outcomes.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE