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Risk of specific cardiovascular diseases in obsessive-compulsive disorder
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Department of Medical Biochemistry and Microbiology, Uppsala Universitet, Uppsala, Sweden.
Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden.
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2020 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 135, p. 189-196Article in journal (Refereed) Published
Abstract [en]

Individuals with obsessive-compulsive disorder (OCD) may have an increased risk of cardiovascular disease (CVD), but evidence for specific types of CVD is limited. This population-based, sibling-controlled cohort study investigated the risk of specific CVD in individuals with OCD. Linking data from various Swedish population-based registers, we explored the risk of a range of CVD in a cohort of individuals diagnosed with OCD between 1973 and 2013 (n = 33,561), compared to matched (1:10) unaffected individuals (n = 335,610). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using conditional Cox proportional hazards regression models, adjusting for history of somatic diseases. To control for familial confounders, we analyzed 23,263 clusters of full siblings discordant for OCD. Individuals with psychiatric comorbidities were systematically excluded to assess the impact of these comorbidities. Over an average follow-up time of 27 years, OCD was associated with an increased risk of a broad range of CVD (adjusted HR [aHR] for any CVD = 1.25 [95% confidence interval [CI], 1.22-1.29]). These associations were strongest for the subtypes venous thrombo-embolism (aHR = 1.48 [95% CI, 1.38-1.58]) and heart failure (aHR = 1.37 [95% CI, 1.28-1.46]). When comparing OCD-exposed individuals with their non-exposed full siblings, results were largely similar. Exclusion of several groups of psychiatric comorbidities resulted in comparable results, albeit attenuated. Individuals with OCD have a moderately increased risk of CVD-related morbidity, independent from history of somatic diseases, familial confounders, and psychiatric comorbidities. The time may be ripe for the development and evaluation of lifestyle interventions to help reduce the risk of cardiovascular morbidity in OCD.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 135, p. 189-196
Keywords [en]
Cardiovascular disease, Cohort study, Morbidity, Obsessive-compulsive disorder, Quasi-experimental design, Sibling comparison
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:oru:diva-89013DOI: 10.1016/j.jpsychires.2020.12.066ISI: 000621425700024PubMedID: 33493948Scopus ID: 2-s2.0-85099921465OAI: oai:DiVA.org:oru-89013DiVA, id: diva2:1523449
Funder
Swedish Society of Medicine, SLS-879801The Karolinska Institutet's Research Foundation, FS-2018:0007
Note

Funding Agency:

Region Stockholm, Stockholm Health Care Services (ALF project) 20180078

Available from: 2021-01-28 Created: 2021-01-28 Last updated: 2025-02-10Bibliographically approved

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Larsson, Henrik

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