Patel P, Ali H, Inayat F, Pamarthy R, Giammarino A, Ilyas F, Smith-Martinez LA, Satapathy SK. Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations: A ten-year United States study. World J Hepatol 2023; 15(2): 289-302 [PMID: 36926245 DOI: 10.4254/wjh.v15.i2.289]
Corresponding Author of This Article
Hassam Ali, MD, Research Scientist, Department of Internal Medicine, East Carolina University Brody School of Medicine, 600 Moye Blvd, Greenville, NC 27834, United States. alih20@ecu.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2023; 15(2): 289-302 Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.289
Table 1 Trends of psychiatric comorbidities in patients hospitalized with primary diagnosis of liver cirrhosis in the national inpatient database from 2009 to 2019, n (%)
Variables
Years
P value
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
GAD
139 (0.17)
97 (0.12)
158 (0.20)
295 (0.38)
225 (0.29)
275 (0.34)
270 (0.42)
245 (0.55)
285 (0.60)
360 (0.71)
480 (0.92)
P < 0.001
Depression
5652 (7)
5835 (8)
6828 (9)
7770 (10)
8599 (11)
9345 (12)
7395 (12)
4885 (11)
5710 (12)
6165 (12)
6264 (12)
P < 0.001
Bipolar disorder
1331(1.69)
1552 (2)
1689 (2)
1630 (2)
1730 (2)
1785 (2)
1575 (3)
1085 (2)
1065 (2)
1210 (2)
1390 (3)
P < 0.001
ADHD
48 (0.06)
78 (0.10)
151 (0.19)
165 (0.21)
130 (0.16)
235 (0.29)
210 (0.33)
75 (0.17)
85 (0.17)
110 (0.21)
130 (0.24)
P < 0.001
Schizophrenia
467 (0.59)
613 (0.79)
491 (0.64)
465 (0.60)
545 (0.70)
535 (0.66)
465 (0.74)
305 (0.69)
400 (0.84)
445 (0.87)
455 (0.87)
P < 0.001
Schizoaffective disorder
150 (0.19)
145 (0.18)
170 (0.22)
205 (0.26)
130 (0.16)
210 (0.26)
215 (0.34)
150 (0.34)
165 (0.34)
200 (0.39)
185 (0.35)
P < 0.001
PTSD
291 (0.36)
230 (0.30)
300 (0.39)
350 (0.45)
440 (0.56)
555 (0.68)
525 (0.83)
350 (0.79)
410 (0.86)
485 (0.95)
490 (0.93)
P < 0.001
Chronic Fatigue
19 (0.02)
28 (0.03)
18 (0.02)
20 (0.03)
25 (0.032)
25 (0.031)
5 (0.007)
40 (0.091)
5 (0.01)
20 (0.039)
45 (0.08)
P < 0.001
Suicidal Ideation
188 (0.23)
235 (0.33)
188 (0.24)
265 (0.34)
235 (0.30)
305 (0.37)
215 (0.34)
105 (0.23)
160 (0.33)
250 (0.48)
295 (0.56)
P < 0.001
Table 2 Associations of common psychiatric conditions based on liver cirrhosis etiology compared against “other” causes of cirrhosis (viral, autoimmune and non-specified)
Variables
Adjusted odds ratio with 95% confidence interval
P value
GAD
Alcoholic liver cirrhosis
1.79 [1.29-2.47]
P < 0.001
NAFLD cirrhosis
1.09 [0.69-1.73]
P = 0.690
Depression
Alcoholic liver cirrhosis
1.18 [1.08-1.29]
P < 0.001
NAFLD cirrhosis
1.14 [1.01-1.28]
P = 0.025
Bipolar disorder
Alcoholic liver cirrhosis
1.62 [1.34-1.96]
P < 0.001
NAFLD cirrhosis
1.37 [1.04-1.79]
P = 0.021
ADHD
Alcoholic liver cirrhosis
1.02 [0.55-1.87]
P = 0.94
NAFLD cirrhosis
1.49 [0.65-3.41]
P = 0.34
Schizophrenia
Alcoholic liver cirrhosis
1.09 [0.76-1.57]
P = 0.60
NAFLD cirrhosis
0.82 [0.45-1.47]
P = 0.51
Schizoaffective disorder
Alcoholic liver cirrhosis
1.18 [0.71-1.94]
P = 0.50
NAFLD cirrhosis
0.41 [0.15-1.13]
P = 0.08
PTSD
Alcoholic liver cirrhosis
1.57 [1.15-2.13]
P = 0.004
NAFLD cirrhosis
1.05 [0.65-1.69]
P = 0.81
Chronic Fatigue
Alcoholic liver cirrhosis
0.16 [0.03-0.73]
P = 0.019
NAFLD cirrhosis
0.73 [0.24-2.20]
P = 0.58
Suicidal ideations
Alcoholic liver cirrhosis
2.01 [1.33-3.04]
P = 0.001
NAFLD cirrhosis
0.51 [0.19-1.32]
P = 0.16
Table 3 Gender disparities with common psychiatric conditions in inflammatory bowel disease hospitalizations (Females compared against males)
Variables
Adjusted odds ratio with 95% confidence interval
P value
GAD
2.56 [2.14-3.06]
P < 0.001
Depression
1.78 [1.71-1.84]
P < 0.001
Bipolar disorder
1.64 [1.52-1.77]
P < 0.001
ADHD
1.07 [0.82-1.39]
P = 0.610
Schizophrenia
0.90 [0.79-1.04]
P = 0.170
Schizoaffective disorder
0.90 [0.73-1.13]
P = 0.390
PTSD
0.83 [0.72-0.97]
P = 0.021
Chronic Fatigue
2.31 [1.31-4.07]
P = 0.004
Suicidal ideation
0.86 [0.71-1.04]
P = 0.120
Table 4 Race disparities with common psychiatric conditions in inflammatory bowel disease hospitalizations (compared against white race)
Variables
Adjusted odds ratio with 95% confidence interval
P value
GAD
Black
0.33 [0.21-0.53]
P < 0.001
Hispanic
0.43 [0.33-0.57]
P < 0.001
Asian/Native American
0.08 [0.01-0.60]
P = 0.014
Depression
Black
0.54 [0.50-0.59]
P < 0.001
Hispanic
0.58 [0.54-0.61]
P < 0.001
Asian/Native American
0.36 [0.30-0.43]
P < 0.001
Bipolar disorder
Black
0.79 [0.69-0.90]
P = 0.001
Hispanic
0.48 [0.43-0.55]
P < 0.001
Asian/Native American
0.16 [0.08-0.29]
P < 0.001
ADHD
Black
0.14 [0.06-0.34]
P < 0.001
Hispanic
0.22 [0.13-0.37]
P < 0.001
Asian/Native American
0.16 [0.02-1.14]
P = 0.068
Schizophrenia
Black
3.10 [2.6-3.66]
P < 0.001
Hispanic
1.05 [0.88-1.26]
P = 0.540
Asian/Native American
0.72 [0.39-1.32]
P = 0.290
Schizoaffective disorder
Black
2.03 [1.50-2.73]
P < 0.001
Hispanic
1.05 [0.79-1.39]
P = 0.710
Asian/Native American
0.66 [0.24-1.79]
P = 0.420
PTSD
Black
0.70 [0.52-0.94]
P = 0.019
Hispanic
0.46 [0.37-0.58]
P < 0.001
Asian/Native American
0.69 [0.39-1.22]
P = 0.210
Chronic Fatigue
Black
0.18 [0.02-01.39]
P = 0.100
Hispanic
0.50 [0.20-1.19]
P = 0.110
Asian/Native American
-
-
Suicidal ideations
Black
0.64 [0.45-0.92]
P = 0.018
Hispanic
0.72 [0.56-0.92]
P = 0.009
Asian/Native American
0.43 [0.16-1.16]
P = 0.097
Citation: Patel P, Ali H, Inayat F, Pamarthy R, Giammarino A, Ilyas F, Smith-Martinez LA, Satapathy SK. Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations: A ten-year United States study. World J Hepatol 2023; 15(2): 289-302