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OCD More Than Triples Risk of Substance Misuse
A diagnosis of obsessive-compulsive disorder (OCD) is associated with a 3.7-fold elevated risk of substance misuse, according to study results published online in JAMA Network Open.
“The findings of this Swedish population-based cohort study challenge the notion that OCD is protective against developing substance misuse,” researchers wrote. “Regular screening for substance use should therefore be included in routine clinical management of patients with OCD, even in children and adolescents.”
The study included a pair of large, prospective cohorts. The first spanned 6.3 million individuals from the general population, 27,342 of whom were diagnosed with OCD. The second encompassed 9230 individuals from a study of twins.
Compared with people without OCD, those with OCD had a 6.7-fold increased risk of drug-related disorders, a 5.2-fold increased risk of death linked with substance use, a 4.5-fold increased risk of alcohol-related disorders, and a 1.2-fold increased risk of a criminal conviction linked with substance use. The hazard ratio for substance misuse with an OCD diagnosis was 3.68 compared with no OCD diagnosis. The increased incidence was evident by age 16, according to the study.
Related: SRI Tapering Possible After Successful Exposure/Response Prevention Therapy for OCD
Associations in the twin cohort were similar. In 18-year-olds, OCD symptoms were concurrently and longitudinally linked with increased alcohol and drug dependence symptoms.
In both cohorts, genetic factors explained approximately 56% to 68% of the association between OCD and substance misuse, while nonshared environmental factors explained 32% to 44%, researchers reported.
“Our results suggest that in contrast to earlier clinical studies, OCD is associated with at least similarly elevated risk of substance misuse, as are other common mental disorders,” they wrote.
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