Mortality Risk May Be Higher in People With OCD
People with obsessive-compulsive disorder (OCD) may have a higher risk of mortality, both all-cause and due to natural causes, than individuals without OCD, according to recent population-based cohort study results published in The BMJ.
“Non-communicable diseases and external causes of death, including suicides and accidents, were major contributors to the risk of mortality in people with OCD,” authors said. “Better surveillance, prevention, and early intervention strategies should be implemented to reduce the risk of fatal outcomes in people with OCD.”
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The study included a population-based cohort of 61,378 individuals in Sweden with OCD, matched in a 1:10 ratio with 613,780 unaffected individuals based on sex, birth year, and county of residence. Additionally, a sibling cohort consisting of 34,085 people with OCD and 47,874 unaffected full siblings was included. The cohorts were followed up for a median of 8.1 years from January 1, 1973, to December 31, 2020.
During the study period, 4,787 individuals with OCD and 30,619 unaffected individuals died, resulting in crude mortality rates of 8.1 and 5.1 per 1,000 person-years, respectively. After adjusting for various factors, individuals with OCD had an increased risk of all-cause mortality (hazard ratio (HR), 1.82), mortality due to natural causes (HR, 1.31), and mortality due to unnatural causes (HR, 3.30). Among natural causes, deaths due to endocrine, nutritional, and metabolic diseases, mental and behavioral disorders, and diseases of the nervous, circulatory, respiratory, and digestive systems were higher in the OCD cohort. The risk of death due to neoplasms was lower in the OCD cohort. Among unnatural causes, suicide showed the highest hazard ratio, followed by accidents.
Authors noted that the inclusion of only specialist care diagnoses in the National Patient Register may have biased the sample towards individuals with more severe OCD and could have limited study results.
“Significant efforts should also be made to promote early detection and improve access to specialist treatment for people with OCD,” authors concluded. “A better integration of mental and physical health care services, the prioritization of prevention while strengthening treatment, and the optimization of intervention synergies across social-ecological levels have been recently proposed as priority action points to prevent premature mortality in people with psychiatric disorders.”
