Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations: A ten-year United States study

doi:10.4254/wjh.v15.i2.289

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Feb 27, 2023 (publication date) through May 5, 2024

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

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

GAD: Generalized anxiety disorder; PTSD: Post-traumatic stress disorder; ADHD: Attention deficit hyperactivity disorder.

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

NAFLD: Non-alcoholic fatty liver disease; GAD: Generalized anxiety disorder; PTSD: Post-traumatic stress disorder; ADHD: Attention deficit hyperactivity disorder.

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

GAD: Generalized anxiety disorder; PTSD: Post-traumatic stress disorder; ADHD: Attention deficit hyperactivity disorder.

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

NAFLD: Non-alcoholic fatty liver disease; GAD: Generalized anxiety disorder; PTSD: Post-traumatic stress disorder; ADHD: Attention deficit hyperactivity disorder.

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
URL: https://www.wjgnet.com/1948-5182/full/v15/i2/289.htm
DOI: https://dx.doi.org/10.4254/wjh.v15.i2.289