2017 IOCDF Grant

The impact of obsessive-compulsive disorder on education, labor market marginalization, and societal cost

Lorena Fernandez de la Cruz, PhD

Karolinska Institutet (Solna, Sweden)

Award Amount: $38,510

OCD typically emerges in childhood or adolescence, may be chronic, and is associated with marked functional impairment, reduced quality of life, and high economic burden for society. The impact of OCD on getting an education, labor market marginalization (including receipt of disability pension, periods of sickness absence, or unemployment), and their associated socioeconomic costs are suspected to be considerable, but previous research has been limited.

Dr. Fernández de la Cruz and her team analyzed data from the Swedish national registers covering several decades and including over 15,000 individuals diagnosed with OCD to investigate: 1) academic performance after compulsory education and highest level of education achieved in individuals with OCD, compared to the general population and their unaffected siblings; 2) labor market entry and marginalization in individuals with OCD, compared to matched individuals from the general population; and 3) economic costs for society. The study found that OCD inflicts substantial burdens on education, work, and quality of life. Youths with OCD experience academic impairment across all subjects and types of education (compulsory, university, and postgraduate), and earlier onset of OCD is associated with worsening performance. Compared to siblings without OCD who grew up in the same environment, siblings with OCD had lower academic performance, suggesting that family factors shared with siblings are not likely to explain the described associations between OCD and education. People with OCD experience significant marginalization in the labor market, characterized by high rates of disability pension, sickness absence from work, and long-term unemployment. Comorbid disorders did not impact these outcomes, suggesting that OCD is a massive force behind these educational, labor, and societal difficulties.

Resulting Publications:

*Pérez-Vigil, A., Fernández de la Cruz, L., Brander, G., Isomura, K., Jangmo, A., Feldman, I., Hesselmark, E., Serlachius, E., Lázaro, L., Rück, C., Kuja-Halkova, R., D’Onofrio, B.M., Larsson, H., & Mataix-Cols, D. (2018). Association of obsessive-compulsive disorder with objective indicators of educational attainment: A nationwide register-based sibling control study. JAMA Psychiatry, 75(1), 47-55. https://doi.org/10.1001/jamapsychiatry.2017.3523

*Pérez-Vigil, A., Mittendorfer-Rutz, E., Helgesson, M., Fernández de la Cruz, L., & Mataix-Cols, D. (2018). Labour market marginalisation in obsessive-compulsive disorder: A nationwide register-based sibling control study. Psychological Medicine, 49(6), 1015-1024. https://doi.org/10.1017/S0033291718001691