Obsessive Compulsive Disorder Associated With Decreased Educational Attainment

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Patients with OCD were significantly less likely to pass all compulsory and additional courses by the end of compulsory school or to access a secondary education program.
Patients with OCD were significantly less likely to pass all compulsory and additional courses by the end of compulsory school or to access a secondary education program.

According to the results of a recent study published in JAMA Psychiatry, obsessive compulsive disorder (OCD) was shown to be associated with reduced academic achievement. The effect was particularly substantial among participants with OCD onset in childhood or adolescence.

The study authors evaluated data from 2,115,554 people born between 1976 and 1998 who were included in a population-based cohort study, and identified those with OCD using the Swedish National Patient Register and International Classification of Diseases-10th edition codes. Sibling-comparison analyses were performed within families with at least 2 siblings (n=726,198) and families with full siblings discordant for OCD (n=11,482). Educational milestones were the main outcomes.

Compared with participants without OCD, those with OCD were significantly less likely to pass all compulsory and additional courses by the end of compulsory school (adjusted odds ratio [OR] range 0.35-0.60), to access a vocational secondary education program (adjusted OR 0.47), or to access an academic secondary education program (adjusted OR 0.61).

OCD was also associated with a lower rate of finishing upper secondary education (adjusted OR 0.43), starting a university degree (adjusted OR 0.72), finishing a university degree (adjusted OR 0.59), or finishing postgraduate education (adjusted OR 0.52).

Similar results were reported in the sibling-comparison models. After exclusion of comorbid psychiatric disorders, estimates were attenuated, but OCD still resulted in decreased educational attainment.

When compared with participants diagnosed with OCD after the age of 18 years, those diagnosed with OCD before age 18 years had lower rates of educational attainment at all educational levels.

In an interview with Psychiatry Advisor, Ana Pérez-Vigil, MD, researcher at the Karolinska Institute, Stockholm, Sweden, and corresponding author on the paper, explained that it was important to do this study because, “physicians who regularly work with persons who have OCD have seen that their patients struggle with schoolwork…but solid, objective evidence for school impairment in OCD was lacking.”

Dr Pérez-Vigil noted that future studies might address whether, “access to and receipt of evidence-based treatment for OCD is associated with a higher likelihood of progressing to higher educational levels.”

Reference

Pérez-Vigil A, Fernández de la Cruz L, Brander G, et al. Association of obsessive-compulsive disorder with objective indicators of educational attainment: a nationwide register-based sibling control study [published online November 15, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.3523

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