{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:41:19Z","timestamp":1787787679750,"version":"build-2784847793"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dig Dis Sci"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psychiatric comorbidities with alcohol use disorder increase the risk of alcohol abuse and relapse. However, updated epidemiologic trends of comorbid psychiatric disorders in patients with alcohol-associated liver disease (ALD) remain limited. We aim to investigate the trends of prevalence of psychiatric comorbidities among those with ALD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population-level cohort study used TriNetX data from over 113 million U.S. patients to assess trends in nine psychiatric disorders from 2015 to 2023 among individuals with ALD, stratified by cirrhosis status and age. In addition, we also compared the trends between patients with ALD and non-ALD chronic liver disease (CLD). Joinpoint regression analyses evaluated temporal trends using annual percentage changes (APC) and average annual percentage changes (AAPC) to identify significant inflection points over the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed significant increases in the prevalence of major depressive disorder (MDD), anxiety, and post-traumatic stress disorder, while schizophrenia and psychotic disorders declined in both ALD with and without cirrhosis groups. In individuals with ALD cirrhosis, schizophrenia and psychotic disorders declined at a greater rate than those without cirrhosis. Stratifying by age, we found older individuals with ALD have a rising trend in seven out of nine psychiatric comorbidities and had a greater increase compared to younger individuals, particularly in MDD, anxiety, and bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with ALD without cirrhosis have the highest psychiatric comorbidity rates. However, trends of prevalence are rising significantly among those with ALD cirrhosis and older adults, highlighting the urgent need for targeted mental health interventions in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10620-025-09494-x","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T13:56:00Z","timestamp":1762437360000},"page":"1493-1504","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in Concurrent Psychiatric Comorbidities in Alcohol-Associated Liver Disease: A Nationwide Study from 2015\u20132023"],"prefix":"10.1007","volume":"71","author":[{"given":"Shu-Yen","family":"Chan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Hui","family":"Yeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunseok","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Delk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natchaya","family":"Polpichai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pojsakorn","family":"Danpanichkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Sheng","family":"Ting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"9494_CR1","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1097\/HEP.0000000000000899","volume":"80","author":"F \u00c5berg","year":"2024","unstructured":"\u00c5berg F, Jiang ZG, Cortez-Pinto H, M\u00e4nnist\u00f6 V. Alcohol-associated liver disease-global epidemiology. Hepatology. 2024;80:1307\u20131322.","journal-title":"Hepatology."},{"key":"9494_CR2","doi-asserted-by":"publisher","first-page":"2436","DOI":"10.1056\/NEJMra2207599","volume":"387","author":"R Bataller","year":"2022","unstructured":"Bataller R, Arab JP, Shah VH. Alcohol-associated hepatitis. N Engl J Med. 2022;387:2436\u20132448.","journal-title":"N Engl J Med."},{"key":"9494_CR3","doi-asserted-by":"publisher","first-page":"30","DOI":"10.14309\/ajg.0000000000002572","volume":"119","author":"LL Jophlin","year":"2024","unstructured":"Jophlin LL, Singal AK, Bataller R et al. ACG clinical guideline: alcohol-associated liver disease. Am J Gastroenterol. 2024;119:30\u201354.","journal-title":"Am J Gastroenterol."},{"key":"9494_CR4","unstructured":"World Health Organization. Global status report on alcohol and health 2018 2018 https:\/\/www.who.int\/publications\/i\/item\/9789241565639."},{"key":"9494_CR5","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1097\/HEP.0000000000000914","volume":"81","author":"P Ochoa-Allemant","year":"2025","unstructured":"Ochoa-Allemant P, Serper M, Wang RX et al. Waitlisting and liver transplantation for MetALD in the United States: An analysis of the UNOS national registry. Hepatology. 2025;81:532\u2013545.","journal-title":"Hepatology."},{"key":"9494_CR6","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/S0140-6736(09)60009-X","volume":"373","author":"MA Schuckit","year":"2009","unstructured":"Schuckit MA. Alcohol-use disorders. Lancet. 2009;373:492\u2013501.","journal-title":"Lancet."},{"key":"9494_CR7","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1097\/HEP.0000000000000344","volume":"80","author":"ML Smith","year":"2024","unstructured":"Smith ML, Wade JB, Wolstenholme J, Bajaj JS. Gut microbiome-brain-cirrhosis axis. Hepatology. 2024;80:465\u2013485.","journal-title":"Hepatology."},{"key":"9494_CR8","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1016\/S2215-0366(19)30222-6","volume":"6","author":"A Castillo-Carniglia","year":"2019","unstructured":"Castillo-Carniglia A, Keyes KM, Hasin DS, Cerd\u00e1 M. Psychiatric comorbidities in alcohol use disorder. Lancet Psychiatry. 2019;6:1068\u20131080.","journal-title":"Lancet Psychiatry."},{"key":"9494_CR9","unstructured":"Dombestein Elde K, Jepsen P, Von Wowern N, et al., (2024) Influence of Comorbidities on Health-Related Quality of Life in Alcohol-Related Liver Disease: A Population-Based Survey. Clin Gastroenterol Hepatol."},{"key":"9494_CR10","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.psychres.2019.05.038","volume":"278","author":"W Sliedrecht","year":"2019","unstructured":"Sliedrecht W, de Waart R, Witkiewitz K, Roozen HG. Alcohol use disorder relapse factors: a systematic review. Psychiatry Res. 2019;278:97\u2013115.","journal-title":"Psychiatry Res."},{"key":"9494_CR11","doi-asserted-by":"publisher","first-page":"929","DOI":"10.3350\/cmh.2024.0278","volume":"30","author":"K Yang","year":"2024","unstructured":"Yang K, Kim S, Yang H et al. The prognostic impact of psychiatric intervention on alcohol-associated liver disease: The UK Biobank cohort study. Clin Mol Hepatol. 2024;30:929\u2013942.","journal-title":"Clin Mol Hepatol."},{"key":"9494_CR12","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1002\/hep.30866","volume":"71","author":"DW Crabb","year":"2020","unstructured":"Crabb DW, Im GY, Szabo G, Mellinger JL, Lucey MR. Diagnosis and treatment of alcohol-associated liver diseases: 2019 practice guidance from the american association for the study of liver diseases. Hepatology. 2020;71:306\u2013333.","journal-title":"Hepatology."},{"key":"9494_CR13","doi-asserted-by":"publisher","first-page":"1910","DOI":"10.1111\/liv.12612","volume":"35","author":"Y Le Strat","year":"2015","unstructured":"Le Strat Y, Le Foll B, Dubertret C. Major depression and suicide attempts in patients with liver disease in the United States. Liver Int. 2015;35:1910\u20131916.","journal-title":"Liver Int."},{"key":"9494_CR14","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.jhep.2021.11.008","volume":"76","author":"VT Kronsten","year":"2022","unstructured":"Kronsten VT, Tranah TH, Pariante C, Shawcross DL. Gut-derived systemic inflammation as a driver of depression in chronic liver disease. J Hepatol. 2022;76:665\u2013680.","journal-title":"J Hepatol."},{"key":"9494_CR15","doi-asserted-by":"publisher","first-page":"1384003","DOI":"10.3389\/fpsyt.2024.1384003","volume":"15","author":"W Liang","year":"2024","unstructured":"Liang W, Zhong K, Lai T et al. Causal relationship between depression and metabolic dysfunction-associated steatotic liver disease: a bidirectional Mendelian randomized study. Front Psychiatry. 2024;15:1384003.","journal-title":"Front Psychiatry."},{"key":"9494_CR16","doi-asserted-by":"publisher","first-page":"2551","DOI":"10.1111\/liv.16019","volume":"44","author":"H \u00c5str\u00f6m","year":"2024","unstructured":"\u00c5str\u00f6m H, Shang Y, Hagstr\u00f6m H, Wester A. Persons with metabolic dysfunction-associated steatotic liver disease are at increased risk of severe depression. Liver Int. 2024;44:2551\u20132563.","journal-title":"Liver Int."},{"key":"9494_CR17","doi-asserted-by":"publisher","first-page":"1357664","DOI":"10.3389\/fendo.2024.1357664","volume":"15","author":"S Shea","year":"2024","unstructured":"Shea S, Lionis C, Kite C et al. Non-alcoholic fatty liver disease and coexisting depression, anxiety and\/or stress in adults: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024;15:1357664.","journal-title":"Front Endocrinol (Lausanne)."},{"key":"9494_CR18","doi-asserted-by":"publisher","first-page":"4846","DOI":"10.3748\/wjg.v27.i29.4846","volume":"27","author":"J Faccioli","year":"2021","unstructured":"Faccioli J, Nardelli S, Gioia S, Riggio O, Ridola L. Neurological and psychiatric effects of hepatitis C virus infection. World J Gastroenterol. 2021;27:4846\u20134861.","journal-title":"World J Gastroenterol."},{"key":"9494_CR19","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1136\/gutjnl-2023-329651","volume":"73","author":"BD Liu","year":"2024","unstructured":"Liu BD, Udemba SC, Liang K et al. Shorter-acting glucagon-like peptide-1 receptor agonists are associated with increased development of gastro-oesophageal reflux disease and its complications in patients with type 2 diabetes mellitus: a population-level retrospective matched cohort study. Gut. 2024;73:246\u2013254.","journal-title":"Gut."},{"key":"9494_CR20","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.7326\/M24-0019","volume":"177","author":"YH Yeo","year":"2024","unstructured":"Yeo YH, Rezaie A, Hsieh TY et al. Shifting trends in the indication of glucagon-like peptide-1 receptor agonist prescriptions: a nationwide analysis. Ann Intern Med. 2024;177:1289\u20131291.","journal-title":"Ann Intern Med."},{"key":"9494_CR21","unstructured":"National Cancer Institute. Joinpoint Trend Analysis Software. Surveillance Research Program US National Cancer Institute: NIH; 2024 [Available from: https:\/\/surveillance.cancer.gov\/joinpoint\/."},{"key":"9494_CR22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.27465","volume":"3","author":"R Meza","year":"2020","unstructured":"Meza R, Jimenez-Mendoza E, Levy DT. Trends in tobacco use among adolescents by grade, sex, and race, 1991\u20132019. JAMA Netw Open. 2020;3:e2027465.","journal-title":"JAMA Netw Open."},{"key":"9494_CR23","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1016\/j.cgh.2023.11.003","volume":"22","author":"M Kalligeros","year":"2024","unstructured":"Kalligeros M, Vassilopoulos A, Vassilopoulos S, Victor DW, Mylonakis E, Noureddin M. Prevalence of steatotic liver disease (MASLD, MetALD, and ALD) in the United States: NHANES 2017\u20132020. Clin Gastroenterol Hepatol. 2024;22:1330\u20132.e4.","journal-title":"Clin Gastroenterol Hepatol."},{"key":"9494_CR24","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1001\/jama.2019.2276","volume":"321","author":"T Wong","year":"2019","unstructured":"Wong T, Dang K, Ladhani S, Singal AK, Wong RJ. Prevalence of alcoholic fatty liver disease among adults in the United States, 2001\u20132016. Jama. 2019;321:1723\u20131725.","journal-title":"Jama."},{"key":"9494_CR25","volume-title":"group NNc","author":"ME Rinella","year":"2023","unstructured":"Rinella ME, Lazarus JV, Ratziu V et al. group NNc. Hepatology: A multi-society Delphi consensus statement on new fatty liver disease nomenclature; 2023."},{"key":"9494_CR26","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1046\/j.1360-0443.2002.00092.x","volume":"97","author":"TM Caldwell","year":"2002","unstructured":"Caldwell TM, Rodgers B, Jorm AF et al. Patterns of association between alcohol consumption and symptoms of depression and anxiety in young adults. Addiction. 2002;97:583\u2013594.","journal-title":"Addiction."},{"key":"9494_CR27","doi-asserted-by":"publisher","first-page":"8696","DOI":"10.3390\/ijerph17228696","volume":"17","author":"YM Chen","year":"2020","unstructured":"Chen YM, Yu TW, Wang CC et al. Characteristics of psychosocial factors in liver transplantation candidates with alcoholic liver disease before transplantation: a retrospective study in a single center in Taiwan. Int J Environ Res Public Health. 2020;17:8696.","journal-title":"Int J Environ Res Public Health."},{"key":"9494_CR28","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1111\/acer.13567","volume":"42","author":"R Jinjuvadia","year":"2018","unstructured":"Jinjuvadia R, Jinjuvadia C, Puangsricharoen P, Chalasani N, Crabb DW, Liangpunsakul S. concomitant psychiatric and nonalcohol-related substance use disorders among hospitalized patients with alcoholic liver disease in the united states. Alcohol Clin Exp Res. 2018;42:397\u2013402.","journal-title":"Alcohol Clin Exp Res."},{"key":"9494_CR29","doi-asserted-by":"publisher","first-page":"289","DOI":"10.4254\/wjh.v15.i2.289","volume":"15","author":"P Patel","year":"2023","unstructured":"Patel P, Ali H, Inayat F, Pamarthy R et al. 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;15:289\u2013302.","journal-title":"World J Hepatol."},{"key":"9494_CR30","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.11619","volume":"8","author":"SY Chan","year":"2025","unstructured":"Chan SY, Yeo YH, Kim H, Polpichai N, Tsai YT, Ting PS. Postdischarge alcohol cessation and psychiatric referrals in alcoholic liver disease. JAMA Netw Open. 2025;8:e2511619.","journal-title":"JAMA Netw Open."},{"key":"9494_CR31","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3390\/jcm10030541","volume":"10","author":"H Gupta","year":"2021","unstructured":"Gupta H, Suk KT, Kim DJ. Gut Microbiota at the Intersection of Alcohol, Brain, and the Liver. J Clin Med. 2021;10:541.","journal-title":"J Clin Med."},{"key":"9494_CR32","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1080\/00365521.2020.1820566","volume":"55","author":"B Bengtsson","year":"2020","unstructured":"Bengtsson B, Askling J, Ludvigsson JF, Hagstr\u00f6m H. Validity of administrative codes associated with cirrhosis in Sweden. Scand J Gastroenterol. 2020;55:1205\u20131210.","journal-title":"Scand J Gastroenterol."}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09494-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-025-09494-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09494-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T08:42:52Z","timestamp":1777970572000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-025-09494-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["9494"],"URL":"https:\/\/doi.org\/10.1007\/s10620-025-09494-x","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]},"assertion":[{"value":"3 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}