Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders

Anna Holmberg; Josep Pol-Fuster; Ralf Kuja-Halkola; Henrik Larsson; Paul Lichtenstein; Zheng Chang; Brian M. D'Onofrio; Isabell Brikell; Anna Sidorchuk; Kayoko Isomura; James J. Crowley; Lina Martinsson; Christian Rück; David Mataix-Cols; Lorena Fernández De La Cruz

doi:10.1136/bmjment-2024-301323

Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders

Anna Holmberg, Josep Pol-Fuster^*, Ralf Kuja-Halkola, Henrik Larsson, Paul Lichtenstein, Zheng Chang, Brian M. D'Onofrio, Isabell Brikell, Anna Sidorchuk, Kayoko Isomura, James J. Crowley, Lina Martinsson, Christian Rück, David Mataix-Cols, Lorena Fernández De La Cruz

^*Corresponding author for this work

Department of Biomedicine - Physiology and Biophysics

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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.

Original language	English
Article number	e301323
Journal	BMJ Mental Health
Volume	28
Issue	1
ISSN	2755-9734
DOIs	https://doi.org/10.1136/bmjment-2024-301323
Publication status	Published - Jan 2025

Keywords

PSYCHIATRY

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10.1136/bmjment-2024-301323

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Holmberg, A., Pol-Fuster, J., Kuja-Halkola, R., Larsson, H., Lichtenstein, P., Chang, Z., D'Onofrio, B. M., Brikell, I., Sidorchuk, A., Isomura, K., Crowley, J. J., Martinsson, L., Rück, C., Mataix-Cols, D., & Fernández De La Cruz, L. (2025). Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders. BMJ Mental Health, 28(1), Article e301323. https://doi.org/10.1136/bmjment-2024-301323

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title = "Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders",

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.",

keywords = "PSYCHIATRY",

author = "Anna Holmberg and Josep Pol-Fuster and Ralf Kuja-Halkola and Henrik Larsson and Paul Lichtenstein and Zheng Chang and D'Onofrio, {Brian M.} and Isabell Brikell and Anna Sidorchuk and Kayoko Isomura and Crowley, {James J.} and Lina Martinsson and Christian R{\"u}ck and David Mataix-Cols and {Fern{\'a}ndez De La Cruz}, Lorena",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2025.",

year = "2025",

month = jan,

doi = "10.1136/bmjment-2024-301323",

language = "English",

volume = "28",

journal = "BMJ Mental Health",

issn = "2755-9734",

publisher = "BMJ Publishing Group",

number = "1",

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Holmberg, A, Pol-Fuster, J, Kuja-Halkola, R, Larsson, H, Lichtenstein, P, Chang, Z, D'Onofrio, BM, Brikell, I, Sidorchuk, A, Isomura, K, Crowley, JJ, Martinsson, L, Rück, C, Mataix-Cols, D & Fernández De La Cruz, L 2025, 'Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders', BMJ Mental Health, vol. 28, no. 1, e301323. https://doi.org/10.1136/bmjment-2024-301323

Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders. / Holmberg, Anna; Pol-Fuster, Josep; Kuja-Halkola, Ralf et al.
In: BMJ Mental Health, Vol. 28, No. 1, e301323, 01.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders

AU - Holmberg, Anna

AU - Pol-Fuster, Josep

AU - Kuja-Halkola, Ralf

AU - Larsson, Henrik

AU - Lichtenstein, Paul

AU - Chang, Zheng

AU - D'Onofrio, Brian M.

AU - Brikell, Isabell

AU - Sidorchuk, Anna

AU - Isomura, Kayoko

AU - Crowley, James J.

AU - Martinsson, Lina

AU - Rück, Christian

AU - Mataix-Cols, David

AU - Fernández De La Cruz, Lorena

PY - 2025/1

Y1 - 2025/1

N2 - 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.

AB - 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.

KW - PSYCHIATRY

UR - http://www.scopus.com/inward/record.url?scp=85215868577&partnerID=8YFLogxK

U2 - 10.1136/bmjment-2024-301323

DO - 10.1136/bmjment-2024-301323

M3 - Journal article

C2 - 39832837

AN - SCOPUS:85215868577

SN - 2755-9734

VL - 28

JO - BMJ Mental Health

JF - BMJ Mental Health

IS - 1

M1 - e301323

ER -

Multigenerational family coaggregation study of obsessive-compulsive disorder and cardiometabolic disorders

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