Mortality among persons with obsessive-compulsive disorder in Denmark

Sandra M. Meier; Manuel Mattheisen; Ole Mors; Diana E. Schendel; Preben B. Mortensen; Kerstin J. Plessen

doi:10.1001/jamapsychiatry.2015.3105

Mortality among persons with obsessive-compulsive disorder in Denmark

Sandra M. Meier, Manuel Mattheisen, Ole Mors, Diana E. Schendel, Preben B. Mortensen, Kerstin J. Plessen

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95 Citas (Scopus)

Resumen

IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers,we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27 236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10 155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54 937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95%CI, 1.31-2.12] for natural causes; MRR, 2.61 [95%CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95%CI, 1.27-2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD.

Idioma original	English
Páginas (desde-hasta)	268-274
Número de páginas	7
Publicación	JAMA Psychiatry
Volumen	73
N.º	3
DOI	https://doi.org/10.1001/jamapsychiatry.2015.3105
Estado	Published - mar. 2016
Publicado de forma externa	Sí

Nota bibliográfica

Funding Information:
This study was supported by the Lundbeck Foundation, within the context of the Lundbeck Foundation Initiative for Integrative Psychiatric Research and Mental Health in Primary Care. Dr Meier received further funding from the Mental Health Services, Capital Region, Copenhagen, Denmark, and Dr Mortensen received funding from the Stanley Medical Research Institute.

Publisher Copyright:
Copyright 2016 American Medical Association. All rights reserved.

ASJC Scopus Subject Areas

Psychiatry and Mental health

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

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title = "Mortality among persons with obsessive-compulsive disorder in Denmark",

abstract = "IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers,we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27 236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10 155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54 937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95%CI, 1.31-2.12] for natural causes; MRR, 2.61 [95%CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95%CI, 1.27-2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD.",

author = "Meier, {Sandra M.} and Manuel Mattheisen and Ole Mors and Schendel, {Diana E.} and Mortensen, {Preben B.} and Plessen, {Kerstin J.}",

note = "Funding Information: This study was supported by the Lundbeck Foundation, within the context of the Lundbeck Foundation Initiative for Integrative Psychiatric Research and Mental Health in Primary Care. Dr Meier received further funding from the Mental Health Services, Capital Region, Copenhagen, Denmark, and Dr Mortensen received funding from the Stanley Medical Research Institute. Publisher Copyright: Copyright 2016 American Medical Association. All rights reserved.",

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doi = "10.1001/jamapsychiatry.2015.3105",

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AU - Meier, Sandra M.

AU - Mattheisen, Manuel

AU - Mors, Ole

AU - Schendel, Diana E.

AU - Mortensen, Preben B.

AU - Plessen, Kerstin J.

N1 - Funding Information: This study was supported by the Lundbeck Foundation, within the context of the Lundbeck Foundation Initiative for Integrative Psychiatric Research and Mental Health in Primary Care. Dr Meier received further funding from the Mental Health Services, Capital Region, Copenhagen, Denmark, and Dr Mortensen received funding from the Stanley Medical Research Institute. Publisher Copyright: Copyright 2016 American Medical Association. All rights reserved.

PY - 2016/3

Y1 - 2016/3

N2 - IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers,we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27 236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10 155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54 937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95%CI, 1.31-2.12] for natural causes; MRR, 2.61 [95%CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95%CI, 1.27-2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD.

AB - IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers,we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27 236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10 155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54 937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95%CI, 1.31-2.12] for natural causes; MRR, 2.61 [95%CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95%CI, 1.27-2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD.

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Mortality among persons with obsessive-compulsive disorder in Denmark

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