increased smoking,32 unhealthy eating patterns,29,33 as well as stress and biological dysregulation,34–36 might have further contributed to the observed excess mortality among persons with OCD. In some cases, the compulsive thoughts and rituals themselves might become harmful.29 We also cannot entirely exclude the possibility that the medication used to treat OCD, such as antidepressants and antipsychotics, have contributed to higher mortality rates.