4.2 Article

Obsessive-compulsive disorder and the associated risk of autoimmune skin diseases: a nationwide population-based cohort study

Journal

CNS SPECTRUMS
Volume 28, Issue 2, Pages 157-163

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1092852921000973

Keywords

Autoimmune skin disease; obsessive-compulsive disorder; cohort study; Taiwan's National Health Insurance Research Database

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There is a significant association between obsessive-compulsive disorder (OCD) and autoimmune skin diseases (ASDs). Patients with OCD have a higher risk of developing ASDs compared to the control group. There are significant associations between OCD and seven individual ASDs.
Background. The concurrent incidence of autoimmune comorbidities in obsessive-compulsive disorder (OCD) is known. However, the association between OCD and related autoimmune skin diseases (ASDs) has not been well studied. Objective. This study aimed to investigate the association between OCD and the risk of ASDs. Methods. To assess the risk of developing ASDs, we recruited 44 324 patients with OCD and 177 296 matched controls from the National Health Insurance Research Database in Taiwan. A Cox regression model was used for the analyses. Results. After adjusting for confounders, an increased risk of ASDs among the patients with OCD (adjusted hazard ratio [aHR]: 6.36; 95% confidence interval [CI]: 5.43-7.45) was found when compared to the controls. Statistically significant associations were found between OCD and seven individual ASDs, including psoriasis (aHR: 12.52; 95% CI: 8.78-17.85), lichen planus (aHR: 27.22; 95% CI: 13.09-56.60), alopecia areata (aHR: 13.69; 95% CI: 9.38-19.98), autoimmune bullous diseases (aHR: 4.30; 95% CI: 2.03-9.11), hidradenitis suppurativa (aHR: 29.95; 95% CI: 3.35-267.62), vitiligo (aHR: 9.35; 95% CI: 5.35-16.32), and lupus erythematosus (aHR: 2.10; 95% CI: 1.52-2.91). Conclusions. Patients with OCD had an increased risk of developing ASDs compared to matched controls. Further studies are required to clarify the underlying mechanisms.

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