Home Medizin Zwangsstörungspatienten haben möglicherweise ein höheres Risiko, sowohl aus natürlichen als auch aus unnatürlichen Gründen zu sterben

Zwangsstörungspatienten haben möglicherweise ein höheres Risiko, sowohl aus natürlichen als auch aus unnatürlichen Gründen zu sterben

von NFI Redaktion


A study from Sweden published in The BMJ today suggests that people with obsessive-compulsive disorder (OCD) may have a higher risk of death from both natural and unnatural causes compared to people without this disorder.

The researchers highlight that many of the natural causes of death are preventable and suggest that better monitoring, prevention, and early intervention strategies should be implemented to reduce the risk of fatal outcomes in people with OCD.

OCD is typically a long-term psychiatric disorder that affects about 2% of the population, characterized by intrusive thoughts, impulses, or images that trigger high levels of anxiety and other distressing feelings—known as obsessions—that the individual tries to neutralize through repetitive behaviors or rituals—known as compulsions.

OCD is also associated with academic underachievement, poor job prospects, alcohol and substance disorders, and an increased risk of death.

Prior studies on specific causes of death in OCD have mainly focused on unnatural causes such as suicide, and little is known about specific natural causes.

To address this knowledge gap, the researchers aimed to estimate the risk of all causes and specific deaths in people with OCD compared to matched, unaffected individuals from the general population and their unaffected siblings.

Using data from several Swedish population registers, they identified 61,378 individuals with OCD and 613,780 individuals without OCD, matched 1:10 for gender, year of birth, and county of residence, as well as a further set of 34,085 individuals with OCD and 47,874 individuals without OCD from sibling groups.

The average age at OCD diagnosis was 27 years, and the groups were followed for an average of 8 years from January 1973 to December 2020.

Overall, individuals with OCD had a higher mortality rate than corresponding individuals without OCD (8.1 compared to 5.1 per 1,000 person-years).

Adjusted for various potentially influential factors such as year of birth, gender, county, migrant status, education, and family income, individuals with OCD had an 82% increased risk of death from any cause.

The additional risk of death was higher for both natural (31% increased risk) and particularly unnatural causes (triple risk).

Among natural causes, individuals with OCD had an increased risk of respiratory diseases (73%), mental and behavioral disorders (58%), diseases of the genitourinary system (55%), endocrine, nutritional, and metabolic diseases (47%), diseases of the circulatory system (33%), nervous system diseases (21%), and digestive system diseases (20%).

Among unnatural causes, suicide had the highest risk of death (almost fivefold), followed by accidents (92% increased risk).

The risk of any cause of death was similar for women and men, although women with OCD had a higher relative risk of dying from unnatural causes compared to men with OCD, likely due to the lower baseline risk in women in the general population, according to the researchers.

In contrast, individuals with OCD had a 10% lower risk of dying from tumors (neoplasms).

Since this is an observational study, the cause cannot be determined. The researchers note that the register data only include diagnoses made in specialized care. It is also unclear if the results can be extrapolated to other settings with different population groups, healthcare systems, and medical practices.

However, this was a large study based on high-quality national data, and the results remained largely unchanged after further adjustment for psychiatric disorders and family factors, implying they withstand careful scrutiny.

Therefore, they conclude, „Non-communicable diseases and external causes of death, including suicides and accidents, contributed significantly to the mortality risk in people with OCD. Better monitoring, prevention, and early intervention strategies should be implemented to reduce the risk of fatal outcomes in people with OCD.“

Source:

Journal reference:

de la Cruz, LF, et al. (2024). All-cause and specific mortality in obsessive-compulsive disorder: nationwide matched cohort and sibling cohort study. BMJ. doi.org/10.1136/bmj-2023-077564.

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