Bipolar disorder and schizophrenia present different risks of atrial fibrillation: A nationwide population-based analysis

Background: Atrial fibrillation (AF) is increasingly prevalent in society, and can elevate cardiac morbidity and mortality. Psychosis and gender are known to play important roles in the genesis of AF. However, it is not clear whether gender modulates the impact of different psychoses on the occurrences of AF. Methods: We identified patients suffering frombipolar disorder and schizophrenia, with and without AF, using the Taiwan National Health Insurance nationwide database. The identified patient population consisted of 927,915 subjects (463,050 males and 464,865 females) from 2001 to 2008, which included 2,963 (3.2‰) schizophrenia patients (1,650 males and 1,313 females) and 5,112 (5.5‰) bipolar-disorder patients (1,934 males and 3,178 females). Results: The male and female bipolar-disorder patients had higher prevalences of AF than did male (16.5‰ vs. 2.4‰, p < 0.001) and female (12.9‰ vs. 2.3‰, p < 0.001) schizophrenia patients. Furthermore, male and female bipolar-disorder patients had higher AF prevalences than did males (8.5‰, p < 0.001) and females (7.2‰, p < 0.001) in the general population. Schizophrenia patients had lower AF prevalence than the general population in male, but not in female gender. Males had a higher AF prevalence than females. However, male and female bipolar disorder and schizophrenia patients had similar AF prevalences. Those patients with schizophrenia and bipolar-disorder patients with AF were older than those without AF. Conclusions: Differing risk factors for AF were identified in bipolar-disorder and schizophrenia patients. Compared to the general population, gender may have different impacts on the occurrence of AF in psychosis patients.