The Mortality Risk of Obsessive-Compulsive Disorder: Insights from a Swedish Study

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The Mortality Risk of Obsessive-Compulsive Disorder: Insights from a Swedish Study

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The Mortality Risk of Obsessive-Compulsive Disorder: Insights from a Swedish Study

Approximately 2% of the global population is affected by obsessive-compulsive disorder (OCD), a mental health condition characterized by persistent and repetitive obsessive thoughts and/or compulsive behaviors.

In China, the prevalence of OCD is estimated to be between 0.1% and 0.3%, with a lifetime prevalence ranging from 0.26% to 0.32%. The peak onset of OCD occurs between the ages of 19 and 35, and at least one-third of patients experience the onset of symptoms before the age of 15.

Individuals with OCD often experience inappropriate and persistent thoughts and impulses, causing intense anxiety and distress. They attempt to alleviate this distress through repetitive behaviors or rituals.

The symptoms of OCD vary widely and can include obsessive thoughts (fear of contamination, need for symmetry, precision, order, etc.) and compulsive behaviors (cleaning, counting, repeating, checking, etc.).

A recent study published in “The BMJ” highlights findings from a Swedish research project, indicating that individuals with OCD have an 82% higher risk of mortality compared to the general population.

Interestingly, the study suggests a 13% decrease in the risk of death from cancer among OCD patients.

This underscores the importance of increased attention, early prevention, and intervention measures to reduce the mortality risk among individuals with OCD.

The study, based on Swedish population data from 1969 onwards, included 61,378 individuals diagnosed with OCD between 1973 and 2020, matched with 613,780 individuals without OCD at a ratio of 1:10. The median follow-up period was 8.1 years, revealing that the median age of initial OCD diagnosis was 26.7 years. OCD patients also exhibited a significantly higher probability of developing other mental health disorders compared to the general population (85.7% vs. 19.6%).

During the follow-up period, 4,748 OCD patients and 30,619 individuals without OCD died. After adjusting for factors such as birth year and gender, the results showed an 82% increase in the risk of death for OCD patients (HR=1.82, 95% CI=1.76~1.98), with a 31% increase in the risk of death from natural causes (HR=1.31, 95% CI=1.27~1.37), and a 3.3 times higher risk of death from non-natural causes (HR=3.30, 95% CI=3.05~3.57).

Specifically, natural causes of death among OCD patients were primarily attributed to respiratory diseases (69% increased risk), mental and behavioral disorders (63% increased risk), endocrine diseases (52% increased risk), nutritional and metabolic diseases (54% increased risk), circulatory system diseases (36% increased risk), neurological diseases (20% increased risk), and digestive system diseases (20% increased risk).

Surprisingly, the study found a 13% decrease in the risk of cancer-related death among OCD patients compared to the general population. While previous research has shown conflicting results regarding cancer incidence and mortality in individuals with mental health disorders, this study did not find similar results, indicating a need for further exploration. The risk of suicide increased nearly 5 times, and the risk of accidental accidents increased by 92% among OCD patients, highlighting the importance of understanding the underlying causes of non-natural deaths and implementing preventive measures.

In conclusion, this population-based matched cohort study reveals that the main factors contributing to the increased risk of death among OCD patients are non-communicable diseases and additional causes of death. The clinical approach should involve proactive monitoring, prevention, and early intervention strategies to reduce the mortality risk associated with OCD.

The Mortality Risk of Obsessive-Compulsive Disorder: Insights from a Swedish Study

Reference:

[1] Fernández de la Cruz L, Isomura K, Lichtenstein P, et al. All cause and cause specific mortality in obsessive-compulsive disorder: nationwide matched cohort and sibling cohort study. BMJ. 2024 Jan 17;384:e077564. doi: 10.1136/bmj-2023-077564. PMID: 38233033; PMCID: PMC10792686.

(source:internet, reference only)

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