People with obsessive-compulsive disorder, known as OCD, are at an increased risk — more than three times higher than those who don’t have the condition — of developing Sjögren’s syndrome, according to a population-based study in Taiwan.
Additionally, among the general population, women and individuals ages 65 and older are more prone to develop Sjögren’s, the study showed.
“We concluded that risk of [Sjögren’s] is significantly increased in patients with OCD compared to those without OCD,” the researchers wrote.
The study, “Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study,” was published in the International Journal of Environmental Research and Public Health.
Psychiatric disorders, including anxiety, cognitive deficits, and mood disorders have been reported to affect patients with Sjögren’s syndrome. These neuropsychiatric manifestations can occur at the early and later stages of the disease.
Obsessive-compulsive disorder is characterized by uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions). Recent research suggests that the prevalence of OCD has increased in people with autoimmune diseases, becoming an extra factor of distress.
However, whether OCD is a risk factor for the development of Sjögren’s syndrome remains largely unknown.
To answer this, a group of researchers in Taiwan conducted a nationwide, population-based analysis of data from the National Health Insurance Research Database or NHIRD.
The NHIRD database contains information on insurance claims, outpatient and emergency room visits, and hospitalizations for almost all of the population — around 23 million people — in Taiwan. The researchers screened data from one million individuals in the NHIRD, with data collected in the 14 years from 1999 to 2013.
Specifically, the team looked for individuals who had been newly diagnosed with OCD, with three or more visits to the hospital or one hospitalization, and no diagnosis of Sjögren’s syndrome.
Individuals without an OCD diagnosis and who did not have Sjögren’s were included as controls. The controls were screened for matching age and gender, and for additional disorders.
The final analysis included 1,678 patients with OCD and 3,356 matched controls. The individuals with obsessive-compulsive disorder had a mean age of 35.6, and included 49.8% women, while the controls had a mean age of 36.1 and were comprised of 50% women.
The overall incidence of Sjögren’s syndrome was markedly higher among people with OCD, with 1.9 cases per 1,000 person-years, than among the controls, for whom the rate was 0.6 cases per 1,000 person-years. Of note, a person-year is a measure of a risk of the disease for a specified population during a specified period. This result was still maintained after adjusting for potential confounding factors, such as age, sex, and co-existing medical conditions (comorbidities).
The results showed that individuals with obsessive-compulsive disorder had a 3.41 times higher risk of developing Sjögren’s than did controls.
Moreover, the risk of Sjögren’s rose significantly during the two years following the OCD diagnosis.
When analyzing the whole group, the risk was the greatest — 5.04 times higher — among those ages 65 and older. Women also were at higher risk than males.
Overall, “this nationwide population-based case-control cohort study revealed that OCD was correlated with a higher risk of incidental [Sjögren’s syndrome],” the researchers wrote.
“Clinicians should be aware that autoimmune symptoms are probable in patients with OCD, especially after a 2-year follow up. Clinically assessing psychiatric stress is important in managing patients with [Sjögren’s syndrome],” the team concluded.