本文由小咖机器人翻译整理

期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2023-077564

摘要内容如下：

客观

评估强迫症（OCD）患者与普通人群中匹配的未受影响的人及其未受影响的兄弟姐妹相比，全因死亡率和特定原因死亡率的风险。

设计

基于人群的配对队列和同胞队列研究。

设置

在瑞典注册链接。

参与者

基于人群的队列研究，包括61378名强迫症患者和613780名未受影响的人，在性别、出生年份和居住的县匹配（1:10）；同胞队列由34085名强迫症患者和47874名未受影响的同胞组成。在1973年1月1日至2020年12月31日期间，队列随访的中位时间为8.1年。

主要结果指标

所有原因和特定原因死亡率。

结果

在研究期间，4787名强迫症患者和30619名未受影响的人死亡（粗死亡率分别为8.1和5.1/1000人年）。在分层Cox比例风险模型中，对出生年份、性别、国家、移民身份（出生在瑞典与国外）和社会人口统计学变量（最新记录的教育、公民身份和家庭收入）进行调整后，强迫症患者的全因死亡率（风险比1.82，95%置信区间1.76至1.89）和自然原因死亡率（1.31，1.27至1.37）和非自然原因死亡率（3.30，第3.05至3.57段）。在自然死亡原因中，内分泌、营养和代谢疾病、精神和行为障碍以及神经、循环、呼吸、消化和泌尿生殖系统疾病在OCD队列中的比例较高。相反，与未受影响的队列相比，OCD队列因肿瘤死亡的风险较低。在非自然原因中，自杀的风险比最高，其次是意外事故。结果对精神疾病合并症和家族混杂因素的调整是稳健的。

结论

非传染性疾病和死亡的外部原因，包括自杀和意外事故，是强迫症患者死亡风险的主要因素。应实施更好的监测、预防和早期干预策略，以降低强迫症患者的死亡风险。

英文原文如下：

Abstracts

OBJECTIVE  To estimate the risk of all cause and cause specific mortality in people with obsessive-compulsive disorder (OCD) compared with matched unaffected people from the general population and with their unaffected siblings.

DESIGN  Population based matched cohort and sibling cohort study.

SETTING  Register linkage in Sweden.

PARTICIPANTS  Population based cohort including 61 378 people with OCD and 613 780 unaffected people matched (1:10) on sex, birth year, and county of residence; sibling cohort consisting of 34 085 people with OCD and 47 874 unaffected full siblings. Cohorts were followed up for a median time of 8.1 years during the period from 1 January 1973 to 31 December 2020.

MAIN OUTCOME MEASURES  All cause and cause specific mortality.

RESULTS  4787 people with OCD and 30 619 unaffected people died during the study period (crude mortality rate 8.1 and 5.1 per 1000 person years, respectively). In stratified Cox proportional hazards models adjusted for birth year, sex, county, migrant status (born in Sweden versus abroad), and sociodemographic variables (latest recorded education, civil status, and family income), people with OCD had an increased risk of all cause mortality (hazard ratio 1.82, 95% confidence interval 1.76 to 1.89) and mortality due to natural causes (1.31, 1.27 to 1.37) and unnatural causes (3.30, 3.05 to 3.57). Among the natural causes of death, those due to endocrine, nutritional, and metabolic diseases, mental and behavioural disorders, and diseases of the nervous, circulatory, respiratory, digestive, and genitourinary systems were higher in the OCD cohort. Conversely, the risk of death due to neoplasms was lower in the OCD cohort compared with the unaffected cohort. Among the unnatural causes, suicide showed the highest hazard ratio, followed by accidents. The results were robust to adjustment for psychiatric comorbidities and familial confounding.

CONCLUSIONS  Non-communicable diseases and external causes of death, including suicides and accidents, were major contributors to the risk of mortality in people with OCD. Better surveillance, prevention, and early intervention strategies should be implemented to reduce the risk of fatal outcomes in people with OCD.

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