Obsessive-compulsive disorder carries increased stroke hazard

Patients with obsessive-compulsive disorder (OCD) are at heightened risk of developing new-onset ischaemic stroke later in life, a study reports.

The study drew data from Taiwan’s National Health Insurance Research Database and included 28,064 adult OCD patients and 28,064 matched non-OCD controls. The average age of the entire population was 37.1 years, and 51.8 percent were women.

Over a mean follow-up of 6.53 years, significantly more OCD patients than controls developed new-onset ischaemic stroke (0.29 percent vs 0.09 percent; p<0.001). There was no significant between-group difference in haemorrhagic stroke (0.08 percent vs 0.05 percent; p=0.188). The OCD group had higher Charlson Comorbidity Index (CCI) scores (p<0.001) and all-cause clinical visits (p<0.001) compared with the control group.

Multivariable Cox analysis confirmed that OCD conferred an increased risk of ischaemic stroke (hazard ratio [HR], 3.02, 95 percent confidence interval [CI], 1.91–4.77), especially among middle-aged (HR, 2.66, 95 percent CI, 1.34–5.29) and elderly adults (HR, 3.46, 95 percent CI, 1.70–7.05). Meanwhile, OCD was not associated with a risk increase for haemorrhagic stroke (HR, 0.87, 95 percent CI, 0.42–1.80).

Among OCD patients, ischaemic and haemorrhagic stroke risks were not influenced by short-term (HR, 1.69, 95 percent CI, 0.74–3.88 and HR, 0.31, 95 percent CI, 0.05–1.95, respectively) and long-term use (HR, 1.37, 95 percent CI, 0.60–3.16 and HR, 0.90, 95 percent CI, 0.22–3.76, respectively) of OCD medications.

The findings highlight the importance of close monitoring for cerebrovascular disease and related risks in patients with OCD. More studies are needed to establish the pathomechanism of OCD associated with an increased risk of ischaemic stroke.