2024-02-20 14:40:04
A new study recently found that people with obsessive-compulsive disorder (OCD) have an increased risk of dying earlier than others, whether from natural or unnatural causes.
Previous work has identified excess mortality among people with OCD, but the specific causes of these deaths have not been further studied – with the possible exception of suicide. In particular, it was found that people suffering from OCD had suicide rates similar to those of people with other mental disorders.
OCD affects approximately 2% of the population. People who suffer from it experience repetitive and intrusive thoughts that plunge them into distress (they are, for example, obsessed by the fear of being contaminated, or of becoming aggressive towards other people). In order to reduce the discomfort caused by their thoughts, they perform extremely time-consuming rituals: rituals of cleaning, repetition, checking, etc.
This disorder significantly degrades their quality of life, affects their relationships as well as their social activities and, generally speaking, their ability to live normally.
My colleagues and I at the Karolinska Institute in Sweden decided to try to understand how deaths from natural causes or those from unnatural causes contribute to the higher mortality seen in people with OCD.
To do this, we relied on Swedish population registers, which include administrative and health data for the entire population of the country. Thanks to these registers, we were able to compare a group of 61,378 individuals diagnosed as suffering from OCD with 613,780 people not affected by this pathology.
The data recorded in these databases allowed us to follow these two groups over a period of more than 40 years, from 1973 to 2020. We thus discovered that people with OCD died at an average age of 69 years, compared to 78 years. those who did not suffer from it.
The risk of death during the period covered by this study was increased by 82% in the group of people with OCD compared to the group who did not have this pathology.
This increased risk of death was found to be attributable to both natural causes (risk increased by 31%) and unnatural causes (risk increased by 230%).
Specific causes
This is the first time that work has identified the specific causes behind “natural” deaths of people suffering from OCD. Our results reveal that the increased risk of mortality which concerns them is due to increased risks of pulmonary disease (73%), mental and behavioral disorders (58%), diseases of the urinary and genital tracts (55%), endocrine, metabolic and nutritional diseases (47%), as well as diseases affecting the blood vessels (33%), the nervous system (21%) and the digestive system (20%).
Interestingly, the risk of death from cancer was 13% lower among people with OCD. The reason why this risk is lower, unlike the risks mentioned above, is not known.
Among the causes of unnatural death, the main contributor to this increased mortality was found to be suicide. The risk of suicide is in fact five times higher among people with OCD than among others. People with OCD also have a 92% higher risk of dying in an accident, particularly in road accidents or following falls.
Taking into account the existence of other mental disorders, such as anxiety, depression, or substance use disorders did not change these results. What is more, the comparison within siblings of people suffering from OCD with their brothers and sisters who did not suffer from it did not modify this result either.
This confirms that this situation is not attributable to additional factors (environmental, genetic, associated mental disorders, etc.), but seems to be linked to the OCD itself.
Largely preventable deaths
These results do not seem particularly positive for people with OCD. However, it is important to note that within the group studied the proportion of people who died from each of the causes mentioned above was relatively low, although compared to the group without OCD, this translates into a higher risk.
Thus, during the period covered by the study, 2.5% of people with OCD died as a result of cardiovascular diseases (heart attacks, strokes, etc.), a rather low percentage. This percentage is nevertheless higher than that observed in the group without OCD, which is more like 1.8%.
Regardless, it is not acceptable for people with OCD to have to deal with these additional risks. We hope that these results will contribute to better care of these patients, in particular by encouraging health professionals to become aware of this situation.
It should be noted that most of the causes of death for which an increased risk has been demonstrated for people with OCD concern external causes (such as suicide, accidents) or non-communicable diseases (cardiovascular diseases, diabetes, chronic lung diseases, mental disorders, neurological disorders, etc.). However, these causes of death are generally considered preventable.
People with OCD also need to be aware that they are affected by the increased risks. This can motivate them to change their behaviors, for example by encouraging them to exercise more and adopt a healthier diet, practices which can play a role in preventing these diseases and the premature deaths associated with them.
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