Association Between Tetralogy of Fallot and Psychiatric Disorders: A Nationwide Cohort Study

Wan Fu Hsu, Wu Chien Chien, Chi Hsiang Chung, Pi Chang Lee, Der Shiun Wang, Shao Wei Huang, Hsin An Chang, Yu Chen Kao, Sung Sen Yang, Nian Sheng Tzeng*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: The tetralogy of Fallot (TOF) has been reported to be associated with some neurodevelopmental impairment and psychiatric disorders. Nevertheless, a nationwide study to clarify the risk between TOF and comorbid psychiatric disorders is lacking. Using a nationwide database in Taiwan, this study aimed to explore the role of TOF in various psychiatric disorders and analyze whether there are patientrelated risk factors. Methods: A total of 16,824 enrolled patients, including 4,206 study subjects who were diagnosed with TOF and 12,618 controls with TOF matched (1:3) for sex, age, hospital visits, and index year, were randomly selected from the Taiwanese National Health Insurance Research Database (NHIRD) between 2000 and 2015. Patients' diagnoses in the NHIRD were encoded using International Classification of Diseases, 9th Revision, Clinical Modification codes. Results: Of patients with TOF, 256 (6.09%) developed psychiatric disorders compared to 394 (3.12%) in the control group. After adjusting for covariates, the adjusted hazard ratio of psychiatric disorders for patients with TOF was 3.192 (95% CI, 2.683-3.798; P < .001). After exclusion of psychiatric diagnoses within the first 5 years, TOF was associated with an increased risk of anxiety (P < .001), depression (P < .001), bipolar disorder (P < .001), and sleep disorders (P = .005). Conclusions: This study revealed that TOF patients have a nearly 3-fold higher risk of psychiatric disorders, including anxiety, depressive, bipolar, and sleep disorders, than the general population. Therefore, continued mental health screening and surveillance are warranted in TOF patients.

Original languageEnglish
Article number19M13126
JournalJournal of Clinical Psychiatry
Volume82
Issue number2
DOIs
StatePublished - Mar 2021

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