Relationship between mental disorders, psychotropic drugs, and constipation in psychiatric outpatients.

Constipation has been reported to be more common in patients with mental disorders than in the general population. However, its relationships with psychiatric diagnosis, medication, age, and sex have not been fully identified. A total of 875 patients from the outpatient department were included in the study. As a retrospective observational study, the psychiatric diagnoses and psychotropic medications were examined based on the medical charts. Fecal conditions, including problems with defecation, abdominal pain, sense of incomplete evacuation, use of laxatives, frequency of defecation, and stool characteristics according to the Bristol Scale, were investigated. The study included 368 males and 507 females, with median ages of 48 and 52 years, respectively. The most common psychiatric diagnoses were depressive disorders (33%), followed by anxiety disorders (19%). Females had significantly higher rates of problems with defecation and laxative use than males (P < .001, P < .0001, respectively). The frequency of laxative use increased significantly with age (P < .0001). The multivariate analyses revealed the close relationship between hypnotics and problems of defecation and that between hypnotics, antipsychotics, and laxative use. In psychiatric outpatients, females had significantly higher rates of problems with defecation and laxative use than males. The use of laxatives significantly increased with age. Problems with defecation were significantly more common in patients taking hypnotics and laxative use was significantly more common in patients taking hypnotics and antipsychotics.

[Attempted suicide of youth with Asperger's disorder].

Research of Asperger's disorder is increasing through strong interest in this disorder. However, there are few reports on suicide attempts among youths with this disorder. We examined the clinical characteristics of serious suicide attempts of adolescents, and indicated the frequency of pervasive developmental disorders among them. In the present study, we reported a suicide attempt using briquettes by a youth with Asperger's disorder aged 23, who had a history of two suicide attempts by hanging. In this case, we examined the predisposing factors to suicide and possible intervention to prevent a re-attempt. As a result, in this case, we suggested that low self-esteem due to repeated serious social failures and feelings of isolation, although there was a social support system, were psycho-social predisposing factors. Moreover, the "conflict" between the patient and his parents, who should have provided social support for him, had made him feel alone. This "conflict" was composed of 1) the primary symptoms of Asperger's disorder (deficit of emotional reciprocity and unreasonable insistence on restricted thoughts.) and 2) his parents' insufficient comprehension of Asperger's disorder. This "conflict" was distinct from the conflict of interpersonal friction based on emotional interaction. In order to prevent a suicide re-attempt, we mainly intervened in the problem of low self-esteem due to repeated serious social failures and having feelings of isolation. We concluded that to prevent a suicide re-attempt in patients with Asperger's disorder, it is important to diagnose and treat the disorder and comorbidity, and it is more important to recognize and aggressively intervene in psycho-social predisposing factors.