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Ali et al. | Journal of Clinical and Translational Research 2023; 9(4): 297-307 299
any statistical significance (P = 0.30) (Figure 1). During the study schizophrenia (0.43%), schizoaffective disorder (0.18%), and
period, there was a higher frequency of females compared to males bipolar disorder (2.28%) showed no significant trend (P > 0.05)
(54% vs. 46%) in hospitalized patients with IBD (P < 0.001). Most (Table 2).
patients belonged to the age group 18–33 years (35%), followed
by 34–49 years (27%) and 50–64 years (21%) (P < 0.001). There 3.3. Gender-based disparities of common psychiatric conditions
was a higher frequency of IBD hospitalizations among Whites in IBD population
(77%), followed by Blacks (14%), and Hispanics (8%) (P = Among hospitalized patients with IBD, females had a
0.052). A vast majority of hospitalized patients with IBD had a higher association with GAD (aOR = 1.74 [95% CI: 1.54–1.97]
Charlson Comorbidity Index (CCI) score of 0 (70%) (P < 0.001). P < 0.001), depression (aOR = 1.85 [95% CI: 1.79–1.92]
Urban teaching hospitals had the highest frequency of IBD P < 0.001), bipolar disorder (aOR = 1.39 [95% CI: 1.29–1.51]
hospitalizations (62%), followed by urban non-teaching (29%) and P < 0.001), PTSD (aOR = 1.38 [95% CI: 1.21–1.57] P < 0.001),
rural (8%) hospitals (P < 0.001). Private insurance remained the and chronic fatigue (aOR = 2.91 [95% CI: 1.71–4.95] P < 0.001),
primary payer for 50% of hospitalized patients with IBD, followed compared to males. There was a lower association with ADHD,
by Medicare (26%) and Medicaid (17%) (P < 0.001). Inpatient schizophrenia, and schizoaffective disorders for females when
mortality significantly decreased from 0.51% in 2009 to 0.32% compared to males with IBD (Table 3).
in 2019 (P = 0.016). The outcomes such as length of stay, mean
inpatient charges, and additional demographic characteristics over 3.4. Race-based disparities of common psychiatric conditions in
the study period are described in Table 1. IBD population
3.2. Prevalence and trends of common psychiatric conditions in Blacks, Hispanics, and Asian/Native Americans had a lower
the IBD population association with GAD, depression, bipolar disorder, PTSD, and
ADHD compared to Whites in hospitalized patients with IBD
The prevalence of GAD in hospitalized patients with IBD was (P < 0.001). Blacks and Hispanics had a higher association
0.83% for the study period, with increasing trends from 0.36% with schizophrenia than Whites (P < 0.001). Blacks also had
in 2009 (2.91/1000 IBD patients) to 1.78% in 2019 (17.8/1000 a higher association with schizoaffective disorder (aOR = 1.66
IBD patients) (P < 0.001). The prevalence of depression was [95% CI: 1.22–2.25] P = 0.001) compared to Whites with
11.81%, with increasing trends from 9% in 2009 (85.7/1000 IBD. There was no significant difference in the association
IBD patients) to 13% in 2019 (133.5/1000 IBD patients) (P < among Hispanics and Asian/Native Americans when compared
0.001). The prevalence of ADHD was 1.04%, with increasing to Whites for schizoaffective disorder. Blacks had a lower
trends from 0.49% in 2009 (4.9/1000 IBD patients) to 2% in association with chronic fatigue compared to Whites (aOR
2019 (15.5/1000 IBD patients) (P < 0.001). The prevalence = 0.43 [95% CI: 0.18–1.001] P = 0.05). For chronic fatigue,
of PTSD was 0.74%, with increasing trends from 0.39% in Hispanics showed no significant difference, whereas Asian/
2009 (3.9/1000 IBD patients) to 1.23% in 2019 (12.3/1000 IBD Native Americans could not be compared due to the smaller
patients) (P < 0.001). The prevalence of somatization (0.004%), sample size (Table 4).

Figure 1. Rate of common psychiatric conditions in primary inflammatory bowel disease (IBD) hospitalizations in the National Inpatient Sample
from 2009 to 2019. Bars show the total IBD hospitalizations per year. The line shows the rate per 1000 IBD hospitalizations for the study period for
psychiatric conditions with significant trends in the present study (P < 0.05).
GAD: Generalized anxiety disorder; ADHD: Attention-deficit hyperactivity disorder; PTSD: Post-traumatic stress disorder.
DOI: http://dx.doi.org/10.18053/jctres.09.202304.22-00231