A0190 - Epidemiology and Risk of Psychiatric Disorders Among Patients with Gastroesophageal Reflux Disease: A Population-Based National Study

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Khaled Alsabbagh Alchirazi, MD

Cleveland Clinic
Cleveland, OH

Khaled Alsabbagh Alchirazi, MD¹, Osama Hamid, MD, MRCPI¹, Ahmed Eltelbany, MD, MPH¹, Motasem Alkhayyat, MD², Madhusudhan Sanaka, MD³, Prashanthi Thota, MD⁴
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Foundation, Cleveland, OH; ³Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH; ⁴Cleveland Clinic, Cleveland, OH

Introduction: Gastroesophageal reflux disease (GERD) is a chronic disease caused by the reflux of the gastric contents into the esophagus. The chronic symptoms of GERD have been shown to negatively impact the psychological and function status of these patients. Therefore, we examined the prevalence of various psychiatric disorders in patients with GERD and factors associated with them.

Methods: We queried a multicenter database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems from 1999 to 2022. A cohort of patients with a Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT) was identified. We identified patients diagnosed with GERD. We collected demographic data, co-morbidities and psychiatric disorders including: anxiety, depression, bipolar disorder, eating disorder, and autistic disorder. Univariate and multivariate analyses were performed using Statistical Package for Social Sciences version 25.

Results: Of the 70, 301,380 adult individuals ( >18 yr old) in the database from 1999 to present, we identified 6,748,3850 patients with GERD (9.7%). Table 1 summarizes the demographic characteristics and co-morbidities of patients in cohort. In univariate analysis, when compared to patients with no history of GERD (controls), GERD patients (cases) were more likely to have anxiety disorder (OR 5.77 [5.76-5.78)]), depression (OR 6.22 [6.21-6.23]), bipolar disorder (OR 4.00 [3.98-4.02], eating disorder (OR 4.58 [4.54-4.62]), and autistic disorder (OR 1.98 [1.95-2.02]) (table 1). In multivariate analysis adjusted for age, gender and race, we re-enforced that GERD was independently associated with higher risk for anxiety (OR 2.84 [2.84-2.85]), depression (3.60 [3.59-3.61]), bipolar disorder (1.34 [1.33-1.34]), eating disorder (1.37 [1.35-1.38]) and autistic disorder (1.17 [1.15-1.20]) (Table 2).

Discussion: In this large study, we found a higher prevalence of various psychiatric diseases including anxiety, depression, bipolar, eating disorder and autism disorder in GERD patients. Further clinical studies exploring the relationship between GERD and psychiatric disorders are required.

Figure: Table 2: Multivariate analysis for psychiatric diagnoses in GERD patients.

	GERD		Non-GERD		OR 95% CI
	Number (Percentage)		Number (Percentage)
Total	6,748,850 9.7%		62,556,240 90.2%
Age ( years)
18-65	3,408,520	51%	44,297,610	71%	0.48 (0.48-0.48)
>65	2,734,010	49%	17,166,600.	27%	2.53 (2.53-2.54)
Gender
Male	3,301,680	41%	28,127,780	45%	0.83 (0.83-0.83)
Female	3,998,130	59%	33,959,060	54%	1.22 (1.22-1.23)
Race
Caucasian	4,999,030	74%	32,318,160	52%	2.67 (2.66-2.68)
African American	776,650	12%	6,219,520	10%	1.26 (1.25-1.27)
Hispanic	59,240	1%	837,650	1%	0.91 (0.89-0.93)
Comorbidities
Smoker	921,230	14%	2,894,580	5%	3.26 (3.25-.266)
Alcohol abuse	269,370	4%	822,040	1%	3.12 (3.10-3.13)
Substance abuse	506,360	8%	1,687,010	3%	2.92 (2.91-2.93)
DM	1,784,190	26%	4,348,050	7%	4.81 (4.80-4.82)
HTN	4,073,950	60%	10,130,140	16%	7.88 (7.86-7.89)
HLD	3,777,920	56%	8,016,350	13%	8.65 (8.63-8.66)
Obesity	1,827,180	27%	3,620,490	6%	6.04 (6.03-6.05)
Anxiety Disorder	1,877,090	28%	3,912,810	6%	5.77 (5.76-5.78)
Depression Disorder	2,249,150	33%	4,651,070	7%	6.22 (6.21-6.23)
Bipolar disorder	312,920	5%	750,170	1%	4.00 (3.98-4.02)
Eating Disorder	63,090	1%	128,500	0.2%	4.58 (4.54-4.62)
Autistic disorder	15,450	0.2%	72,220	0.1%	1.98 (1.95-2.02)

Table: Table 1: Baseline Characteristic of Patients with GERD (cases) and without GERD (Controls).
abbreviations: GERD: Gastroesophageal reflux disease; DM: Diabetes mellitus; HTN: Hypertension; HLD: Hyperlipidemia.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Ahmed Eltelbany indicated no relevant financial relationships.

Motasem Alkhayyat indicated no relevant financial relationships.

Madhusudhan Sanaka indicated no relevant financial relationships.

Prashanthi Thota indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi, MD¹, Osama Hamid, MD, MRCPI¹, Ahmed Eltelbany, MD, MPH¹, Motasem Alkhayyat, MD², Madhusudhan Sanaka, MD³, Prashanthi Thota, MD⁴. A0190 - Epidemiology and Risk of Psychiatric Disorders Among Patients with Gastroesophageal Reflux Disease: A Population-Based National Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.