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Ali et al. | Journal of Clinical and Translational Research 2023; 9(4): 297-307 301
Table 3. Gender-based disparities with common psychiatric conditions
Table 2. Trends of psychiatric comorbidities in patients hospitalized with a primary diagnosis of inflammatory bowel disease in the National Inpatient Sample database from 2009
P-values <0.001 <0.001 0.31 0.37 <0.001 0.90 0.56 <0.001 0.16 in inflammatory bowel disease hospitalizations (females compared
against males)
Variables Adjusted odds ratio with P-values
95% confidence interval
2019 1255 (1.78%) 9375 (13%) 5 (<1%) 1590 (2%) 1090 (2%) 340 (0.48%) 145 (<1%) 870 (1.23%) 60 (<1%) GAD 1.74 (1.54–1.97) <0.001
1.85 (1.79–1.92)
<0.001
Depression
4.8 (0.57–3.98)
0.14
Somatization 1.39 (1.29–1.51) <0.001
Bipolar disorder
2018 955 (1.38%) 8555 (12%) 0 (0%) 1350 (2%) 870 (1%) 365 (1%) 165 (<1%) 700 (1%) 55 (<1%) ADHD 0.77 (0.69–0.86) <0.001
0.43 (0.36–0.51)
Schizophrenia
<0.001
Schizoaffective disorder 0.67 (0.52–0.86) 0.002
2017 870 (1.29%) 8325 (12%) 5 (<1%) 1415 (2%) 855 (1%) 365 (1%) 210 (<1%) 675 (1%) 55 (<1%) PTSD 1.38 (1.21–1.57) <0.001
Chronic fatigue
<0.001
2.91 (1.71–4.95)
GAD: Generalized anxiety disorder; ADHD: Attention-deficit hyperactivity disorder;
PTSD: Post-traumatic stress disorder
2016 720 (1.1%) 8219 (12%) 0 (0%) 1325 (2%) 755 (1%) 290 (<1%) 120 (<1%) 540 (1%) 35 (<1%) 4. Discussion
This study found a decrease in hospitalizations with IBD as a
primary diagnosis. While there has been an overall increase in IBD
2015 410 (0.72%) 7720 (14%) 0 (0%) 1365 (2%) 750 (1%) 265 (<1%) 85 (<1%) 540 (1%) 20 (<1%) cases, newer and more effective treatments have possibly resulted
in a drop in hospital admissions. Our findings show that several
psychiatric disorders are becoming more common in hospitalized
patients with IBD. Whites were more commonly associated with
Years 2014 640 (0.84%) 10365 (14%) 5 (<1%) 1865 (2%) 960 (1%) 270 (<1%) 115 (<1%) 560 (1%) 50 (<1%) GAD, depression, bipolar disorder, PTSD, and ADHD compared
to Blacks, Hispanics, and Asian/Native Americans. Furthermore,
GAD: Generalized anxiety disorder; ADHD: Attention-deficit hyperactivity disorder; PTSD: Post-traumatic stress disorder.
females had a higher association with GAD, depression, bipolar
disorder, PTSD, and chronic fatigue than male IBD patients.
IBD patients may have a significantly higher prevalence of
2013 445 (0.59%) 10210 (14%) 0 (0%) 1690 (2%) 775 (1%) 300 (<1%) 125 (<1%) 505 (1%) 50 (<1%) serious psychological distress (7.4% vs. 3.4%) compared to those
without IBD [16]. A retrospective cohort study from Canada

disorders in IBD patients than in the general population, including
2012 390 (0.51%) 9160 (12%) 5 (<1%) 1895 (2%) 700 (1%) 300 (<1%) 165 (<1%) 430 (0%) 29 (<1%) revealed an increased incidence and prevalence of psychiatric
anxiety, depression, and bipolar disorder [9]. In our study,
depression was the most common psychiatric disorder among IBD
374 (0.47%) 7182 (9%) 1826 (2%) 606 (1%) 336 (0.43%) patients. Mardini et al. demonstrated that in patients with Crohn’s
disease, the presence of depressive symptoms was associated with
2011 4 (<1%) 278 (<1%) 82 (<1%) 37 (<1%) increased disease activity over an 18-month follow-up [17]. The
presence of depression has also been shown to increase the risk
of relapse in IBD and can lead to reduced quality of life and low
2010 292 (0.38%) 7060 (9%) 10 (<1%) 1860 (2%) 479 (1%) 283 (<1%) 117 (<1%) 350 (0.46%) 22 (<1%) medication adherence [18-20].
IBD patients with anxiety have been shown to have an
increased risk of surgery, poorer treatment compliance, and
decreased quality of life [18,21,22]. A study in Switzerland
2009 221 (0.36%) 6500 (9%) 0 (0%) 1748 (2%) 377 (0.49%) 331 (0.43%) 123 (<1%) 302 (0.39%) 30 (<1%) showed an increased recurrence of IBD in patients with depression
and anxiety [23]. A Korean study revealed that IBD patients in
remission with concomitant functional gastrointestinal and mood
disorders demonstrated a lower health-related quality of life [24].
The young adult patients face multiple financial, academic, and

developing psychiatric disorders [25]. Our study also showed
an increased rate of IBD hospitalizations in young adults. It may
to 2019 Variables GAD Depression Somatization Bipolar disorder ADHD Schizophrenia Schizoaffective disorder PTSD Chronic fatigue personal challenges, which may lead to an increased risk of
potentially be attributed to the worsening of IBD disease activity
due to the aforementioned factors in this age group.
DOI: http://dx.doi.org/10.18053/jctres.09.202304.22-00231