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Constipation is associated with an increased risk of depression: A systematic review and meta-analysis of observational studies
Constipation affects not only gastrointestinal health but also psychological well-being. Its relationship with depression has garnered attention, particularly in the context of gut–brain axis dysfunction. However, prior epidemiological data have been inconsistent regarding this association.
To clarify this relationship, a systematic review and meta-analysis were conducted, focusing on observational studies examining the association between constipation and depression in the general population. Extensive searches of databases such as PubMed, Web of Science, Embase, and the Cochrane Library were conducted, including literature from their inception until October 1, 2025. The analysis used random-effects models to estimate pooled odds ratios (ORs) with 95% confidence intervals (CIs), and assessed heterogeneity, prediction intervals, subgroup differences, sensitivity, and potential publication bias.
The meta-analysis encompassed 18 studies and aggregated data from 730,263 participants. Findings indicated that constipation correlates significantly with an increased risk of depression, evidenced by an OR of 2.08 (95% CI: 1.84–2.34). Notably, the analysis revealed substantial heterogeneity (I² = 92.6%). Importantly, this association persisted robustly across various sensitivity tests. More pronounced associations were identified among adolescents, within studies conducted in Asia and North America, in studies with smaller participant sizes, and where depression assessments were self-reported. The prediction interval analysis further confirmed a persistent positive association across multiple demographic groups.
In conclusion, this comprehensive meta-analysis substantiates a significant association between constipation and a heightened risk of depression. These results emphasize the necessity for a collaborative approach to gastrointestinal and mental health care, especially regarding younger individuals experiencing chronic constipation. Additionally, they advocate for further prospective and mechanistic research focused on the dynamics of the gut–brain axis. [NPID: Constipation, depression, gut-brain axis]
Year: 2026
