Multigenerational Family Coaggregation Study of Obsessive-compulsive Disorder and Cardiometabolic Disorders

Overview

Journal BMJ Ment Health

Date 2025 Jan 20

PMID 39832837

Authors

Anna Holmberg

Josep Pol-Fuster

Ralf Kuja-Halkola

Henrik Larsson

Paul Lichtenstein

Zheng Chang

Brian M DOnofrio

Isabell Brikell

Anna Sidorchuk

Kayoko Isomura

James J Crowley

Lina Martinsson

Christian Ruck

David Mataix-Cols

Lorena Fernandez de la Cruz

Affiliations

Soon will be listed here.

Abstract

Background: Obsessive-compulsive disorder (OCD) is associated with an increased risk of morbidity and mortality due to cardiometabolic disorders. Whether this association is driven by familial factors is unknown. This population-based family study explored the familial co-aggregation of OCD and cardiometabolic disorders.

Methods: We identified 6 049 717 individuals born in Sweden between 1950 and 2008, including 50 212 individuals with OCD, and followed them up to 2020. These individuals were linked to their mothers, fathers, full siblings, maternal and paternal half siblings, aunts, uncles and cousins. We estimated the risk of cardiovascular diseases (CVD) and metabolic disorders (including obesity, type 2 diabetes and hyperlipidaemia), comparing the relatives of probands with and without OCD. Cox proportional hazards regression models, incorporating time-varying exposures, estimated HRs.

Results: OCD was associated with an increased risk of CVD (HR 1.47; 95% CI 1.43 to 1.51), obesity (HR 1.69; 95% CI 1.63 to 1.74), type 2 diabetes (HR 2.01; 95% CI 1.90 to 2.12) and hyperlipidaemia (HR 1.42; 95% CI 1.33 to 1.52). The relatives of probands with OCD exhibited small increased risks of CVD (HRs from 1.01 to 1.11) and obesity (HRs from 1.03 to 1.20). Slightly increased risks for type 2 diabetes were observed in mothers (HR 1.11; 95% CI 1.07 to 1.15) and full siblings (HR 1.12; 95% CI 1.05 to 1.20), while for hyperlipidaemia it was only observed in mothers (HR 1.06; 95% CI 1.02 to 1.10).

Conclusions: Our results do not support a major contribution of familial factors to the association between OCD and cardiometabolic disorders, suggesting a more prominent role of unique environmental factors.

References

Virtanen S, Kuja-Halkola R, Sidorchuk A, Fernandez de la Cruz L, Ruck C, Lundstrom S . Association of Obsessive-Compulsive Disorder and Obsessive-Compulsive Symptoms With Substance Misuse in 2 Longitudinal Cohorts in Sweden. JAMA Netw Open. 2022; 5(6):e2214779. PMC: 9171556. DOI: 10.1001/jamanetworkopen.2022.14779. View

Fernandez de la Cruz L, Isomura K, Lichtenstein P, Ruck C, Mataix-Cols D . Morbidity and mortality in obsessive-compulsive disorder: A narrative review. Neurosci Biobehav Rev. 2022; 136:104602. DOI: 10.1016/j.neubiorev.2022.104602. View

Dahlen T, Zhao J, Magnusson P, Pawitan Y, Lavrod J, Edgren G . The frequency of misattributed paternity in Sweden is low and decreasing: A nationwide cohort study. J Intern Med. 2021; 291(1):95-100. DOI: 10.1111/joim.13351. View

Chen C, Liao W, Chattopadhyay A, Lu T . Exploring the genetic correlation of cardiovascular diseases and mood disorders in the UK Biobank. Epidemiol Psychiatr Sci. 2023; 32:e31. PMC: 10227537. DOI: 10.1017/S2045796023000252. View

Chu C, Chou P, Lin C, Cheng C, Tsai C, Lan T . Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study. PLoS One. 2016; 11(9):e0162239. PMC: 5017574. DOI: 10.1371/journal.pone.0162239. View

Fullana M, Mataix-Cols D, Caspi A, Harrington H, Grisham J, Moffitt T . Obsessions and compulsions in the community: prevalence, interference, help-seeking, developmental stability, and co-occurring psychiatric conditions. Am J Psychiatry. 2009; 166(3):329-36. PMC: 3818089. DOI: 10.1176/appi.ajp.2008.08071006. View

Blanco-Vieira T, Radua J, Marcelino L, Bloch M, Mataix-Cols D, do Rosario M . The genetic epidemiology of obsessive-compulsive disorder: a systematic review and meta-analysis. Transl Psychiatry. 2023; 13(1):230. PMC: 10307810. DOI: 10.1038/s41398-023-02433-2. View

Correll C, Detraux J, De Lepeleire J, De Hert M . Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry. 2015; 14(2):119-36. PMC: 4471960. DOI: 10.1002/wps.20204. View

Sjolander A, Dickman P . Why test for proportional hazards-or any other model assumptions?. Am J Epidemiol. 2024; 193(6):926-927. PMC: 11579528. DOI: 10.1093/aje/kwae002. View

10.

Mataix-Cols D, Fernandez de la Cruz L, Beucke J, de Schipper E, Kuja-Halkola R, Lichtenstein P . Heritability of Clinically Diagnosed Obsessive-Compulsive Disorder Among Twins. JAMA Psychiatry. 2024; 81(6):631-632. PMC: 10993148. DOI: 10.1001/jamapsychiatry.2024.0299. View

11.

Sevilla-Cermeno L, Isomura K, Larsson H, Akerstedt T, Vilaplana-Perez A, Lahera G . Insomnia in obsessive-compulsive disorder: A Swedish population-based cohort study. J Affect Disord. 2020; 266:413-416. DOI: 10.1016/j.jad.2020.01.122. View

12.

Pillinger T, Osimo E, de Marvao A, Shah M, Francis C, Huang J . Effect of polygenic risk for schizophrenia on cardiac structure and function: a UK Biobank observational study. Lancet Psychiatry. 2023; 10(2):98-107. DOI: 10.1016/S2215-0366(22)00403-5. View

13.

Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C . The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry. 2019; 6(8):675-712. DOI: 10.1016/S2215-0366(19)30132-4. View

14.

Akbari M, Seydavi M, Chasson G, Leventhal A, Lockwood M . Global prevalence of smoking among individuals with obsessive-compulsive disorder and symptoms: a systematic review and meta-analysis. Health Psychol Rev. 2022; 17(3):505-519. PMC: 10495108. DOI: 10.1080/17437199.2022.2125037. View

15.

Isomura K, Brander G, Chang Z, Kuja-Halkola R, Ruck C, Hellner C . Metabolic and Cardiovascular Complications in Obsessive-Compulsive Disorder: A Total Population, Sibling Comparison Study With Long-Term Follow-up. Biol Psychiatry. 2018; 84(5):324-331. DOI: 10.1016/j.biopsych.2017.12.003. View

16.

Isomura K, Sidorchuk A, Brander G, Jernberg T, Ruck A, Song H . Risk of specific cardiovascular diseases in obsessive-compulsive disorder. J Psychiatr Res. 2021; 135:189-196. DOI: 10.1016/j.jpsychires.2020.12.066. View

17.

Bergstrom M, Modin B, Fransson E, Rajmil L, Berlin M, Gustafsson P . Living in two homes-a Swedish national survey of wellbeing in 12 and 15 year olds with joint physical custody. BMC Public Health. 2013; 13:868. PMC: 3848933. DOI: 10.1186/1471-2458-13-868. View

18.

Holmberg A, Martinsson L, Lidin M, Ruck C, Mataix-Cols D, Fernandez de la Cruz L . General somatic health and lifestyle habits in individuals with obsessive- compulsive disorder: an international survey. BMC Psychiatry. 2024; 24(1):98. PMC: 10840209. DOI: 10.1186/s12888-024-05566-w. View

19.

Isomura K, Nordsletten A, Ruck C, Ljung R, Ivarsson T, Larsson H . Pharmacoepidemiology of obsessive-compulsive disorder: A Swedish nationwide cohort study. Eur Neuropsychopharmacol. 2016; 26(4):693-704. DOI: 10.1016/j.euroneuro.2016.02.004. View

20.

Nota J, Sharkey K, Coles M . Sleep, arousal, and circadian rhythms in adults with obsessive-compulsive disorder: a meta-analysis. Neurosci Biobehav Rev. 2015; 51:100-7. DOI: 10.1016/j.neubiorev.2015.01.002. View