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Risk of specific cardiovascular diseases in obsessive-compulsive disorder

Risk of specific cardiovascular diseases in obsessive-compulsive disorder

Title: Risk of specific cardiovascular diseases in obsessive-compulsive disorder
Author: Isomura, Kayoko
Sidorchuk, Anna
Brander, Gustaf
Jernberg, Tomas
Rück, Andreas
Song, Huan   orcid.org/0000-0003-3845-8079
Valdimarsdóttir, Unnur Anna
Lichtenstein, Paul
Larsson, Henrik
Rück, Christian
... 2 more authors Show all authors
Date: 2021-03
Language: English
Scope: 8
Department: Faculty of Medicine
Series: Journal of Psychiatric Research; 135()
ISSN: 0022-3956
DOI: https://doi.org/10.1016/j.jpsychires.2020.12.066
Subject: Áráttu- og þráhyggjuröskun; Hjartasjúkdómar; Cardiovascular disease; Cohort study; Morbidity; Obsessive-compulsive disorder; Quasi-experimental design; Sibling comparison; Obsessive-Compulsive Disorder/epidemiology; Cardiovascular Diseases/epidemiology; Humans; Sweden/epidemiology; Cohort Studies; Siblings; Psychiatry and Mental Health; Biological Psychiatry
URI: https://hdl.handle.net/20.500.11815/2928

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Isomura , K , Sidorchuk , A , Brander , G , Jernberg , T , Rück , A , Song , H , Valdimarsdóttir , U A , Lichtenstein , P , Larsson , H , Rück , C , Mataix-Cols , D & Fernández de la Cruz , L 2021 , ' Risk of specific cardiovascular diseases in obsessive-compulsive disorder ' , Journal of Psychiatric Research , vol. 135 , pp. 189-196 . https://doi.org/10.1016/j.jpsychires.2020.12.066


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.


This work was supported by grants from Region Stockholm, Stockholm Health Care Services (ALF project, grant number 20180078), the Swedish Medical Association [Svenska Läkaresällskapet] (grant reference SLS-879801), and Karolinska Institutet (grant reference FS-2018:0007) awarded to Dr. Fernández de la Cruz. Publisher Copyright: © 2020 The Author(s)

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