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The Connection between Cardiac and Mental Disorder: Atrial Fibrillation in Patients with Psychiatric Disorder.

Atrial fibrillation (AF) is the most common tachyarrhythmia in clinical practice, and is associated with an increased risk of cardiovascular complication and mortality. 1 Several risk factors, such as old age, male sex, diabetes mellitus, hypertension, valvular disease, ischemic heart disease, heart failure, obesity, and elevated inflammatory marker concentrations have been proposed to increase the occurrences of AF, 2 which contribute to high healthcare system utilization rates and socio-economic costs. 3 Therefore, diagnosis and treatment AF is of substantial clinical value. Social stigma and discrimination previously added to the disability in patients with psychiatric disorders and delayed the understanding of its associated comorbidities. Illness prevention and advancement of mental health strategies in Taiwan help to solve the issue of social exclusion and clarify the co-existing underlying diseases. In this issue of Acta Cardiologica Sinica ,Y ang et al. investigated the prevalence of AF in patients with schizophrenia and bipolar disorder, two of the most common psychiatric disorders, and shed light on the connection between heart and mental disorder. The study also elucidated the impact of gender factors on the occurrences of AF by using community-based National Health Insurance inpatient database. 4 The authors demonstrated several interesting findings which may have an important impact on future surveys of AF in patients with psychiatric disorders. THE PREVALENCE OF AF IN PATIENTS WITH SCHIZOPHRENIA AND BIPOLAR DISORDER First, the present study 4 demonstrated a different prevalence of AF in patients with psychiatric disorders. Patients with bipolar disorder displayed a higher prevalence of AF than did patients with schizophrenia and the general population. The incidence of newly diagnosed AF in patients with bipolar disorder was significantly higher than those in patients with schizophrenia and general population, which reflected the heterogeneous effects of different psychiatric disorders on the genesis of AF. In patients with schizophrenia, there were fewer new AF occurrences, which re-emphasized the lower incidence of AF in patients with schizophrenia 5 and that different psychiatric disorders could have distinct manner on the occurrences of AF. The medical comorbidities, consistent with previous report, 5 were significantly higher in patients with bipolar diseases than those with schizophrenia, which may cause the higher prevalence of AF in patients with bipolar disorder, as a manifestation of underlying system diseases.