Kim Jin S, Chang Patrick W, Hung Jason, Wang Hohui E, Chen Mu-Hong, Sheibani Sarah, Odufalu Florence-Damilola, Dodge Jennifer L, Zhang Bing
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California.
J Clin Psychiatry. 2025 Jan 2;86(1):24m15339. doi: 10.4088/JCP.24m15339.
We compared substance use disorder (SUD) prevalence among adult inflammatory bowel disease (IBD) hospitalizations with non-IBD controls from the 2016-2018 National Inpatient Sample, assessing correlations with demographics, socioeconomic status, geographic regions, depression, and anxiety. The primary aim focused on SUD, defined as substance abuse or dependence (: F10-F19) excluding unspecified use or remission, among hospitalizations documenting IBD (Crohn's disease or ulcerative colitis; : K50-51) as one admitting diagnosis (IBD-D). The prevalence of SUD among hospitalizations with and without IBD was compared. The secondary aim further characterized factors influencing SUD among hospitalizations with IBD as the primary diagnosis (IBD-PD). Multivariable logistic regression was performed to estimate the adjusted odds ratios (ORs) for SUD including associated covariates. SUD prevalence was 20.9% for IBD-D and 20.8% for non-IBD controls ( = .38). After adjustments, there was less SUD (OR 0.92, 95% CI, 0.90-0.93) but more opioid use disorder (OUD) (OR 1.20, 95% CI, 1.15-1.24) among IBD-D; other substances were less likely among IBD-D. Among IBD-PD hospitalizations, SUD significantly associated with Crohn's disease (75.1% vs 58.8%, < .001), Medicaid (30.4% vs 15.8%, < .001), lowest-income quartile (32.8% vs 23.8%, < .001), depression (19.1% vs. 12.5%), and anxiety (24.7% vs. 14.9%). These factors were also associated with OUD. Notably, certain geographic regions and urbanization levels correlated with both elevated SUD and OUD among IBD-PD hospitalizations. We comprehensively characterized SUD prevalence among adult IBD hospitalizations, identifying demographic, socioeconomic, geographic, and mental health risk factors for SUD and OUD in IBD. These findings inform efforts to decrease SUD among IBD patients by improving health care delivery through reducing health care disparities and improving psychiatric care.
我们比较了2016 - 2018年全国住院患者样本中成年炎症性肠病（IBD）住院患者与非IBD对照者的物质使用障碍（SUD）患病率，评估其与人口统计学、社会经济地位、地理区域、抑郁和焦虑的相关性。主要目标聚焦于在将IBD（克罗恩病或溃疡性结肠炎；编码：K50 - 51）作为一项入院诊断（IBD - D）的住院患者中，定义为物质滥用或依赖（编码：F10 - F19，不包括未明确说明的使用或缓解情况）的SUD。比较了有IBD和无IBD的住院患者中SUD的患病率。次要目标进一步对以IBD作为主要诊断（IBD - PD）的住院患者中影响SUD的因素进行了特征描述。进行多变量逻辑回归以估计包括相关协变量在内的SUD的调整优势比（OR）。IBD - D组的SUD患病率为20.9%，非IBD对照组为20.8%（P = 0.38）。调整后，IBD - D组中SUD较少（OR 0.92，95%可信区间，0.90 - 0.93），但阿片类物质使用障碍（OUD）较多（OR 1.20，95%可信区间，1.15 - 1.24）；IBD - D组中使用其他物质的可能性较小。在IBD - PD住院患者中，SUD与克罗恩病（75.1%对58.8%，P < 0.001）、医疗补助（30.4%对15.8%，P < 0.001）、最低收入四分位数（32.8%对23.8%，P < 0.001）、抑郁（19.1%对12.5%）和焦虑（24.7%对14.9%）显著相关。这些因素也与OUD相关。值得注意的是，某些地理区域和城市化水平与IBD - PD住院患者中SUD和OUD的升高均相关。我们全面描述了成年IBD住院患者中SUD的患病率，确定了IBD中SUD和OUD的人口统计学、社会经济、地理和心理健康风险因素。这些发现为通过减少医疗保健差异和改善精神科护理来改善医疗服务提供，从而降低IBD患者中SUD的努力提供了信息。
