Psychiatric Disorder in Anorectal Dyssynergia

Psychiatric Disorder Clinical Trial

Official title:

Psychiatric Assessment of Patients With Anorectal Dyssynergia and the Impact on the Quality of Life

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06128031
• Other study ID #: psycosis&anorectal dyssynergia
• Status: Not yet recruiting
• Start date: November 1, 2023
• Est. completion date: September 2025

Study information

• Verified date: November 2023
• Source: Assiut University
• Contact: Dina M Hussein, resident
• Phone: 01016434312
• Email: dinamedhat772[@]gmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

1. evaluate psychiatric disorders among patients with anorectal dyssynergia

2. evaluate the effect of delayed diagnosis of anorectal dyssynergia on the quality of the life

Description:

Functional constipation is a functional bowel disorder that presents as persistently difficult, infrequent, or seemingly incomplete defecation.

Subjective and objective definitions of constipation include:

(1) straining, hard stools (hard, inspissated stool), unproductive calls ("want to but cannot"), infrequent stools, or incomplete evacuation. (2) <3 bowel movements per week, daily stool weight <35 g/day, or straining >25% of the time Dyssynergia defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stool The etiology of dyssynergic defecation is unclear however it was found that the problem began during childhood in 31% of patients, and after a particular event, such as pregnancy, trauma, or back injury in 29% of patients, and there was no cause in 40% of patients.

The first step in making a diagnosis of dyssynergic defecation is to exclude an underlying metabolic or pathologic disorder .A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights.

. anorectal dyssynergia impact quality of life and cause psychiatric problems such as of anxiety, depression, obsessive compulsiveness, psychoticism, and somatization.

So, the investigators aim to evaluate psychiatric disorders among those patients and impact of delayed diagnosis on their quality of life.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 100
• Est. completion date: September 2025
• Est. primary completion date: September 1, 2025
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• patients diagnosed as anorectal dyssynergia with anorectal manometric study

Exclusion Criteria:

• patient with diabetes mellitus ,hypertension ,chronic kidney disease ,and chronic liver disease patients

• patient with neurological disease

• patient with thyroid disease

• patient with past history of psychiatric disorders

• patients with past or current medications or substance induced psychiatric disorders

Related Conditions & MeSH terms

• Anorectal Disorder
• Ataxia
• Mental Disorders
• Problem Behavior
• Psychiatric Disorder
• Rectal Diseases

Intervention

Other:
• questionaire
Psychiatric interview: this will be assessed by (SCID-5)semi structural clinical interview based on Diagnostic and Statistical manual of Mental disorders-5 criteria -Psychometric assessment include; Hamilton depression rating scale(7) and Hamilton anxiety rating scale(8) , used to score the symptoms of anxiety or depression Quality of life assessment: will be assessed by the Patient assessment of constipation-quality of life questionnaire

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

References & Publications (7)

Hosseinzadeh ST, Poorsaadati S, Radkani B, Forootan M. Psychological disorders in patients with chronic constipation. Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):159-63. — View Citation

Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91. doi: 10.1053/j.gastro.2005.11.061. Erratum In: Gastroenterology. 2006 Aug;131(2):688. — View Citation

Rao SS, Mudipalli RS, Stessman M, Zimmerman B. Investigation of the utility of colorectal function tests and Rome II criteria in dyssynergic defecation (Anismus). Neurogastroenterol Motil. 2004 Oct;16(5):589-96. doi: 10.1111/j.1365-2982.2004.00526.x. — View Citation

Rao SS, Seaton K, Miller MJ, Schulze K, Brown CK, Paulson J, Zimmerman B. Psychological profiles and quality of life differ between patients with dyssynergia and those with slow transit constipation. J Psychosom Res. 2007 Oct;63(4):441-9. doi: 10.1016/j.jpsychores.2007.05.016. Epub 2007 Aug 1. — View Citation

Rao SS, Tuteja AK, Vellema T, Kempf J, Stessman M. Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. J Clin Gastroenterol. 2004 Sep;38(8):680-5. doi: 10.1097/01.mcg.0000135929.78074.8c. — View Citation

Shear MK, Vander Bilt J, Rucci P, Endicott J, Lydiard B, Otto MW, Pollack MH, Chandler L, Williams J, Ali A, Frank DM. Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH-A). Depress Anxiety. 2001;13(4):166-78. — View Citation

Williams JB. A structured interview guide for the Hamilton Depression Rating Scale. Arch Gen Psychiatry. 1988 Aug;45(8):742-7. doi: 10.1001/archpsyc.1988.01800320058007. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	1-Assess psychiatric disorders among patients with anorectal dyssynergia	Review the different types of psychiatric disorders in patients have diagnosed anorectal dyssynergia using SCID-5 ,anxiety and depression Hamilton score (from 0-4,zero refer to no symptoms ,4 refer to sever symptoms ), the summation of them show the type and severity of the condition	through study completion, an average of 1 year
Secondary	The impact of anorectal dyssynergia on the quality of the life	By using survey contain 36 short question about the quality of the life of the patient with anorectal dyssynergia and compare the answer with those of normal people	Through study completion, an average of 1 year