Racial and gender-based disparities and trends in common psychiatric conditions for patients with inflammatory bowel disease in the United States: an 11-year national cross-sectional study
Background and Aim: Inflammatory bowel disease (IBD) is a chronic, debilitating disease that has been extensively studied. However, the clinical evidence remains limited regarding the racial and gender-based disparities in psychiatric illnesses in IBD patients. We aim to evaluate trends and sociodemographic disparities in psychiatric disorders in patients with IBD.
Methods: The United States National Inpatient Sample (NIS) database was retrospectively investigated from 2009 to 2019 to report trends and disparities in common psychiatric comorbidities in hospitalized patients with IBD.
Results: For the study period (2009–2019), the prevalence of generalized anxiety disorder (GAD) in IBD patients increased from 0.36% to 1.78%, depression increased from 9% to 13%, attention-deficit hyperactivity disorder (ADHD) increased from 0.49% to 2%, and post-traumatic stress disorder (PTSD) increased from 0.39% to 1.23% (p < 0.001). The prevalence of somatization (0.004%), schizophrenia (0.43%), schizoaffective disorder (0.18%), and bipolar disorder (2.28%) showed no significant trend (p > 0.05). Compared to males, females had a higher association with GAD, with an adjusted odds ratio (aOR) of 1.74 (95% CI 1.54–1.97, p < 0.001), depression (aOR 1.85 [95% CI 1.79–1.92] p < 0.001), bipolar disorder (aOR 1.39 [95% CI 1.29–1.51] p < 0.001), PTSD (aOR 1.38 [95% CI 1.21–1.57] p < 0.001), and chronic fatigue (aOR 2.91 [95% CI 1.71–4.95] p < 0.001). Blacks, Hispanics, and Asian/Native Americans had a lower association with psychiatric illnesses compared to Whites (p < 0.001).
Conclusions: This study shows a rising prevalence of common psychiatric disorders in hospitalized patients with IBD, particularly in females. These mental illnesses were more commonly associated with Whites than Blacks, Hispanics, and Asian/Native Americans.
Relevance for patients: Our findings highlight the need for effective screening and treatment protocols for psychiatric disorders in patients with IBD. It can potentially improve the quality of life and medication adherence and reduce the use of valuable healthcare resources. Prompt recognition of these mental illnesses followed by early treatment initiation can be of paramount clinical importance for sustained IBD remission.
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