Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study

Abstract

Obsessive-compulsive disorder (OCD) includes a wide range of symptoms and is often associated with comorbidities. Although psychiatric involvement may be an early manifestation of Sjögren’s syndrome (SS), only a few studies have demonstrated the relationship between OCD and SS. This is a nationwide cohort study identifying the risk of SS in OCD patients. We studied a longitudinal health insurance database for the period from 1999 to 2013. The study group was OCD patients with at least three outpatient visits or one hospitalization. The comparison cohort was matched by age and sex, as well as comorbidities. We calculated the risk of Sjögren’s syndrome using Cox proportional hazard regression models. We performed a propensity score match for confounders and effect modifiers between the two groups. The propensity score probability was estimated through logistic regression. Primary outcome was the incidental SS. A total of 1678 patients with OCD (49% women, mean age: 35.6 years) and 3356 controls were followed up, resulting in 13,077 and 25,856 person-years, respectively. The hazard ratio for developing SS was 3.31 (95% C.I.: 1.74–6.28) in patients with OCD, compared to those without OCD after adjusting for age, sex, and comorbidities. Furthermore, the risk of SS significantly increased over the 2-year follow-up period after OCD diagnosis. We concluded that risk of SS is significantly increased in patients with OCD compared to those without OCD. Clinically, Sjögren’s symptoms in OCD patients should be regularly assessed.

Psychiatric disorders in paediatric-onset immune-mediated inflammatory diseases: a nationwide Danish study

“…An increased risk of psychiatric disorders before pIMID onset was also reported by a Canadian study, where adults with IBD and rheumatoid arthritis had an increased risk of anxiety and depression in the years preceding their IMID diagnosis 25. Also, in a study from Taiwan, patients with obsessive compulsive disorder (anxiety disorder) had an increased risk of Sjögren’s disease (connective tissue disease) 26. One could speculate if the increase in psychiatric disorders, especially emotional disorders, before pIMID onset are triggered by early IMID symptoms such as pain and fatigue.…”

Exploring the Psychiatric Manifestations of Primary Sjögren’s Syndrome: A Narrative Review

“…These conditions include various psychiatric disorders [ 11 ]. The comorbid psychiatric disorders include cognitive dysfunction [ 12 ], depression [ 13 ], bipolar mood disorder [ 14 ], psychosis [ 15 , 16 ], catatonia [ 15 , 17 ], and obsessive-compulsive disorder [ 11 , 18 ]. Cognitive dysfunction, often called “brain fog,” is the most common psychiatric manifestation reported by pSS patients.…”