Risk of acute myocardial infarction and ischemic stroke in young patients with Somatic Symptom Disorder: A nationwide study in Korea

Abstract

Introduction Psychiatric disorders are known to influence cardiovascular risk profiles (CvRP) and be associated with increased cardiovascular morbidity, particularly among older adults. However, the cardiovascular implications of Somatic Symptom Disorder (SSD), especially in younger populations, remain poorly understood. This study aimed to assess the risk of acute myocardial infarction (AMI) and ischemic stroke in individuals with SSD using a nationwide population-based cohort. Methods We analyzed data from the Korean National Health Insurance claims database, including 349,703 individuals diagnosed with SSD and 1,398,812 age- and sex-matched controls. CvRP indicators—such as body mass index (BMI), blood pressure, fasting glucose, lipid levels, and health behaviors—were compared between groups. Results Despite similar CvRP between groups, individuals with SSD exhibited a significantly higher risk of AMI (adjusted hazard ratio [HR], 1.16; 95 % confidence interval [CI], 1.09–1.24) and ischemic stroke (HR, 1.27; 95 % CI, 1.21–1.34). These risks were particularly elevated among younger individuals (aged 20–29) and females. Sensitivity analyses excluding other psychiatric comorbidities confirmed the robustness of these findings. Conclusion While cardiovascular risk is typically emphasized in older populations, our findings highlight that young individuals with SSD also face elevated risks of AMI and ischemic stroke. These results underscore the need for early identification and intervention strategies in this at-risk population, particularly among young women.