OCD sufferers still live shorter lives than the rest of us

OCD sufferers still live shorter lives than the rest of us

A recent study from Sweden found that people who feel excessively concerned about their health tend to die earlier than those who do not. It seems strange that obsessives, who are anxious, by definition, but have nothing wrong with them, should have a shorter lifespan than the rest of us. Let’s find out more.

First, a word about terminology. The term “hypochondriac” quickly became a pejorative. Instead, we medical professionals are encouraged to use the term pathological anxiety disorder (IAD). So, to avoid offending our more sensitive readers, we must use this term.

We can define IAD as a mental health condition characterized by excessive anxiety about health, often accompanied by an unfounded belief in the presence of a serious medical condition. It may be associated with frequent visits to the doctor, or it may involve avoiding them altogether on the grounds that a real and potentially fatal condition may be diagnosed.

The last alternative seems to me to be quite rational. The hospital is a dangerous place and you can die in a place like this.

IAD can be quite debilitating. A person with this condition will spend a lot of time worrying and visiting clinics and hospitals. It is expensive for health systems due to the time and diagnostic resources used, and is highly stigmatizing.

Busy healthcare professionals prefer to spend time treating people with “real conditions” and can often be quite dismissive. And so can the public.

Now, about that study

Swedish researchers tracked about 42,000 people (of whom 1,000 had IAD) over two decades. During that period, people with the disorder were more likely to die. (On average, anxious people die five years younger than those who worry less.) Moreover, the risk of death from natural and unnatural causes increased. Maybe people with IAD have something wrong with them after all.

People with IAD dying of natural causes had increased deaths from cardiovascular causes, respiratory causes and unknown causes. Interestingly, they did not have an increase in deaths from cancer. This seems strange because cancer anxiety is common among this population.
The leading cause of unnatural death in the IAD group was suicide, with at least a fourfold increase compared to those without IAD.

How do we explain these strange results?

IAD is known to have a strong relationship with psychiatric disorders. Since the risk of suicide is increased by mental illness, this finding seems quite plausible. If we add the fact that people with IAD may feel stigmatized and rejected, this may contribute to anxiety and depression, ultimately leading to suicide in some cases.

It seems that explaining the increased risk of death from natural causes is not easy. There may be lifestyle factors. Alcohol, smoking, and drug use are more common in anxious people and those with a psychological disorder. It is known that such vices can limit a person’s longevity and thus may contribute to increased mortality due to IAD.

IAD is known to be more common in those who have had a family member with a serious illness. Since many serious diseases have a genetic component, there may be good constitutional reasons for this increase in mortality: lifespan is shortened due to “defective” genes.

What can we learn?

Doctors should be alert to patients’ underlying health problems and should listen more carefully. When we ignore our patients, we are often poorly detected. Perhaps people with IAD have a hidden underlying disorder, and I accept this unpopular conclusion.

Perhaps we can illustrate this point with the case of the French novelist Marcel Proust. Proust’s biographers often describe him as a hypochondriac, but he died in 1922 at the age of 51, at a time when the average Frenchman’s life expectancy was 63.

During his life, he complained of numerous digestive symptoms such as fullness, bloating, and vomiting, yet his therapists found nothing wrong. In fact, what he described is consistent with gastroparesis.

This is a condition in which the stomach has less movement and empties more slowly than it should, causing it to become overfilled. This can lead to vomiting, and with that comes the risk of inhaling the vomit, leading to aspiration pneumonia and Proust is known to have died from complications of pneumonia.

Finally, a word of caution: writing about IAD can be risky. French playwright Molière wrote Le Malade Imaginaire (The Imaginary Invalid), a play about a hypochondriac named Argan who tries to convince his daughter to marry a doctor in order to reduce his medical bills. As for Molière, he died during the fourth performance of his work. Make fun of hypochondriacs at your own risk.Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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