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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations: A ten-year United States study
Pratik Patel, Hassam Ali, Faisal Inayat, Rahul Pamarthy, Alexa Giammarino, Fariha Ilyas, Lucia Angela Smith-Martinez, Sanjaya K Satapathy
Pratik Patel, Department of Gastroenterology, Mather Hospital and Hofstra University Zucker School of Medicine, Port Jefferson, NY 11777, United States
Hassam Ali, Rahul Pamarthy, Fariha Ilyas, Department of Internal Medicine, East Carolina University Brody School of Medicine, Greenville, NC 27834, United States
Faisal Inayat, Department of Internal Medicine, Allama Iqbal Medical College, Lahore 54550, Punjab, Pakistan
Alexa Giammarino, Department of Internal Medicine, North Shore University Hospital and Hofstra University Zucker School of Medicine, Port Jefferson, NY 11777, United States
Lucia Angela Smith-Martinez, Department of Psychiatry, East Carolina University Brody School of Medicine, Greenville, NC 27834, United States
Sanjaya K Satapathy, Department of Hepatology, North Shore University Hospital and Hofstra University Zucker School of Medicine, Manhasset, NY 11030, United States
Author contributions: Patel P, Ali H, Inayat F, Pamarthy R, and Giammarino A contributed to conceptualization, methodology, software, data curation, validation, writing, and original draft preparation; Ilyas F and Smith-Martinez LA contributed to writing, reviewing, editing, and supervision; Satapathy SK project administration, supervision, and critical revision of the manuscript; all authors had access to the study data and reviewed and approved the final manuscript.
Institutional review board statement: Patients’ data was not acquired by any specific institution but rather open-access United States National Inpatient Sample (NIS) data. The NIS contains de-identified information, protecting the privacy of patients, physicians, and hospitals. Therefore, it was deemed exempt from the institutional review board (IRB).
Informed consent statement: Participants were not required to give informed consent for this retrospective study since the analysis of baseline characteristics used anonymized clinical data.
Conflict-of-interest statement: There is no conflict of interest associated with publication of this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: 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
Received: October 17, 2022
Peer-review started: October 17, 2022
First decision: December 24, 2022
Revised: January 1, 2023
Accepted: January 31, 2023
Article in press: January 31, 2023
Published online: February 27, 2023
ARTICLE HIGHLIGHTS
Research background
Chronic liver disease is associated with various neuropsychiatric conditions, such as generalized anxiety disorder (GAD) and major depression. The psychological stress experienced by patients with cirrhosis can negatively affect their mental health.
Research motivation
There is limited data assessing and comparing the prevalence of psychiatric conditions based on patient profiles and the etiology of cirrhosis.
Research objectives
To examine the trends of hospitalizations among common psychiatric conditions in cirrhosis based on gender, race, and the etiology of liver disease over 11 years in the United States by dividing the etiology of cirrhosis into alcohol, non-alcoholic fatty liver disease, and other causes (viral, autoimmune, or unspecified) using the National Inpatient Sample (NIS) 2009-2019.
Research methods
The present study utilized the NIS database to identify patients with a primary diagnosis of liver cirrhosis from January 2009 to December 2019 and assess the prevalence of common psychiatric conditions that included GAD, major depressive disorder, bipolar disorder, attention-deficit/hyperactivity disorder, schizophrenia, schizoaffective disorder, post-traumatic stress disorder, chronic fatigue, and suicidal ideation.
Research results
Our study showed an uptrend in psychiatric comorbidities over the last decade, with racial and gender disparities.
Research conclusions
The findings of this study revealed a remarkably increasing rate of psychiatric diagnoses in cirrhotics. Therefore, it is imperative for clinicians to understand and recognize associated disparities based on gender and race.
Research perspectives
Our study suggests that all liver cirrhosis patients should be provided a referral to a mental health professional at the time of diagnosis, and more studies are needed to look into the etiology of these diagnoses.
