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302 Ali et al. | Journal of Clinical and Translational Research 2023; 9(4): 297-307
Table 4. Racial disparities with common psychiatric conditions in fluctuations, alterations in microbiome composition, and various
inflammatory bowel disease hospitalizations (compared against environmental factors can possibly contribute to these trends [26].
White race) In addition, it is also critical to take into account the fact that
Variables Adjusted odds ratio with P-values women are more likely than men to face physical, sexual, and
95% confidence interval emotional abuse [27]. These factors could also be driving the
GAD observed gender differences in mental health disorders among IBD
White - patients in our analysis. Moreover, it is known that women with
Black 0.42 (0.34–0.53) <0.001 IBD show increased odds of poor maternal and fetal outcomes,
Hispanic 0.53 (0.40–0.69) <0.001 and a pre-pregnancy IBD diagnosis may increase the risk for
Asian/Native American 0.15 (0.04–0.47) 0.001 mood and anxiety disorders [28,29].
Depression Smoking is a known risk factor for the development of Crohn’s
White - disease in both males and females [30]. A Swiss study found that
Black 0.62 (0.59–0.66) <0.001 young women had a higher smoking rate of 51.7% than young
Hispanic 0.60 (0.56–0.65) <0.001 men [31]. Similarly, a Dutch study revealed that there were more
Asian/Native American 0.39 (0.32–0.48) <0.001 female current smokers among patients with IBD than males [32].
Bipolar disorder The higher smoking rate in young females may contribute to the
White - increased IBD-related hospitalizations observed in our study. The
Black 0.77 (0.68–0.86) <0.001 present study showed an increased prevalence of anxiety in female
Hispanic 0.71 (0.61–0.83) <0.001 IBD patients, which mirrors the gender differences in anxiety
Asian/Native American 0.30 (0.18–0.51) <0.001 among the general population [33]. Genetic predisposition due
ADHD to known susceptibility gene variants is one of the causes of the
White - increased prevalence of IBD in the female population. Females
are more commonly associated with familial than sporadic IBD
Black 0.22 (0.17–0.28) <0.001 (61% vs. 54%) [34]. Females are also more likely to develop
Hispanic 0.33 (0.25–0.44) <0.001 ulcerative colitis if they have a single nucleotide polymorphism in
Asian/Native American 0.22 (0.10–0.47) <0.001 the promoter region of interleukin-10 [35]. A number of immune-
Schizophrenia mediated diseases result from the loss of the X-chromosome
White - in peripheral T and B lymphocytes, including primary biliary
Black 3.84 (3.2–4.60) <0.001 cholangitis, autoimmune thyroid disease, Raynaud’s syndrome,
Hispanic 1.52 (1.14–2.02) 0.004 and systemic sclerosis [36,37]. A similar mechanism may
Asian/Native American 0.56 (0.21–1.51) 0.25 contribute to the prevalence of IBD in females. However, the
Schizoaffective disorder exact mechanism remains unclear. Compared to males, IBD in
White - females is more often associated with a negative body image and
Black 1.66 (1.22–2.25) 0.001 reduced sexual activity [38,39]. This may further contribute to
Hispanic 0.88 (0.54–1.44) 0.62 the development of psychiatric disorders. Other factors that result
Asian/Native American 0.79 (0.25–2.45) 0.69 in gender disparities among IBD patients include occupation,
PTSD lifestyle, and dietary habits. However, a clear causal relationship
White remains to be established.
Black 0.57 (0.46–0.72) <0.001 Racial disparities among IBD patients have previously been
Hispanic 0.62 (0.47–0.81) 0.001 studied. However, less is known about their impact on IBD
Asian/Native American 0.46 (0.23–0.93) 0.032 patients with common psychiatric conditions. IBD is typically
Chronic fatigue more prevalent among populations in Western and Northern
White - Europe [40]. However, its incidence among non-White populations
Black 0.43 (0.18–1.001) 0.05 has also increased in recent years [41]. In our study, Whites had
Hispanic 0.39 (0.12–1.26) 0.11 the highest rate of IBD hospitalizations (77%), followed by
Asian/Native American - - Blacks (14%) and Hispanics (8%). In a large survey-based study,
GAD: Generalized anxiety disorder; ADHD: Attention-deficit hyperactivity disorder; Wang et al. revealed similar findings in the United States [42].
PTSD: Post-traumatic stress disorder. Moreover, in a recent retrospective study based on 132,894 IBD
hospitalizations with substance use disorder, White was the most
In our study, females had a higher frequency of IBD common race (N = 98,147; 79%) [43]. Our data showed that
hospitalizations than males. Furthermore, female IBD patients GAD, depression, bipolar disorder, PTSD, and ADHD were more
were more commonly associated with diagnoses of GAD, prevalent in White IBD patients than in Black, Hispanic, and
depression, bipolar disorder, PTSD, and chronic fatigue. An Asian/Native American IBD patients. In contrast, a retrospective
increased genetic susceptibility to psychiatric disorders, hormonal cohort study conducted at a large urban outpatient center revealed

DOI: http://dx.doi.org/10.18053/jctres.09.202304.22-00231