Association of COVID 19 pandemic with new onset Obsessive-Compulsive Disorder (OCD) symptomology in the medical students – A cross sectional study

Abstract

AimsObsessive-Compulsive Disorder (OCD) is an anxiety disorder, which is the sixth largest contributor to non-fatal health loss globally. Coronavirus disease (COVID-19) pandemic, aside from its impact on physical health, has also had its effects on mental health. This study aimed to explore the frequency of new onset OCD symptomology in medical students amidst COVID-19 pandemic and its association with potential sociodemographic parameters.MethodThis cross-sectional study was conducted among medical students studying in Pakistani medical colleges. Data were collected after ethical approval from 1st January 2020 to 20th January 2020 during the second COVID-19 wave. Participants with a history of diagnosed psychiatric illness such as OCD, bipolar disorder, depression, anxiety and those taking relevant medications were excluded from the study. The online questionnaire included Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Revised Padua Inventory-Contamination Subscale (PI-CS), which were used to assess OCD symptoms and aversion for contamination respectively. Participants filled Y-BOCS twice, once for pre-pandemic score (based on self-recall), and a second time during 2nd wave of COVID-19. Data were analysed using IBM SPSS v23.0 (Armonk, N.Y., USA).ResultThe study included 711 participants (Males: 29.8%, Mean age: 21.59 ± 1.52 years) from over 46 medical colleges and over 44 cities of Pakistan. The mean pre-pandemic and mid-2nd wave Y-BOCS scores were 11.86 ± 6.02 and 15.61 ± 7.41 respectively. The mean PI-CS score was 17.27 ± 9.17. Twenty five percent (n = 176) of students developed new onset OCD symptomology during pandemic, while seventy percent (n = 497) suffered from worsened Y-BOCS score during pandemic. New onset OCD symptomology was associated with age less than 20 years (p = 0.02), higher PI-CS score (p = 0.001) and studying in preclinical years (p = 0.002). Worsening of YBOCS score had significant association with female gender (p = 0.02), attending pandemic related awareness seminar (p = 0.027), studying in preclinical years (p < 0.001) and age less than 20 years (p < 0.001). High Padua scorers (16 and above) showed significant association with increase in YBOCS score (p < 0.000), age less than 20 years (p = 0.005), preclinical years (p = 0.001), frequency of engagements in pandemic related discussions (p = 0.001) and change in YBOCS score (p < 0.001).ConclusionOur findings indicate that the prevalence of OCD symptomology increased during the COVID-19 pandemic as demonstrated by increased Y-BOCS scores.Femal medical students and students in preclinical years are more likely to suffer from psycological impact of COVID-19 pandemic and heightened concerns and fear for contamination.

Effects of the COVID-19 Pandemic on University Students' Mental Health: A Literature Review

“…Other variables as predictors for OCD in the general population may also apply to university students: being single places people at 1.836 times increased risk of having OCD, the presence of an increase in sleep latency is an independent predictor for OCD, and a history of psychiatric comorbidity. Mazhar et al [ 39 ] observed that female medical students in junior preclinical years are more likely to suffer symptoms of OCD at increased rates in contrast to male students. Fears, depression, eating disorders, and other stress-inducing factors had a magnifying effect that contributed to increased OCD prevalence in students during the pandemic [ 37 ].…”

“…This review finds that the COVID-19 pandemic negatively affected the mental health of university students, and the following trends have been identified: (1) decreased mental health: these psychological trends include increased stress, anxiety, self-reported decreased well-being, constant worry, etc. [ 1 , 3 , 4 , 6 , 9 , 10 , 12 - 23 , 26 - 28 , 30 , 31 , 33 , 34 , 46 ]; (2) psychiatric trends include the presence of depression, substance abuse, and increased psychiatric morbidity, including an increase in OCD occurrence as well as suicidal ideation [ 1 , 16 - 19 , 23 , 24 , 26 , 28 , 30 - 37 , 39 , 41 , 42 , 48 ]; (3) disruption of the circadian cycle trends, sleep disorders, and insomnia [ 10 , 14 - 16 , 19 , 20 , 46 ]; (4) the disproportional detrimental effect of COVID-19 on female students in all areas reviewed [ 3 , 6 , 9 , 13 - 16 , 20 , 28 - 31 ].…”

“…This review finds that the COVID-19 pandemic negatively affected the mental health of university students, and the following trends have been identified: (1) decreased mental health: these psychological trends include increased stress, anxiety, self-reported decreased well-being, constant worry, etc. [1,3,4,6,9,10,[12][13][14][15][16][17][18][19][20][21][22][23][26][27][28]30,31,33,34,46]; (2) psychiatric trends include the presence of depression, substance abuse, and increased psychiatric morbidity, including an increase in OCD occurrence as well as suicidal ideation [1,[16][17][18][19]23,24,26,28,[30][31][32][33][34][35][36][37]39,41,42,48]; (3) disruption of the circadian cycle trends, sleep disorders, and insomnia…”

Genel Popülâsyonda Obsesif Kompulsif Semptomların Yordayıcısı Olarak COVID-19 Stresi ve Bu İlişkide Duygu Düzenleme Güçlüğü, Obsesif İnançlar ve Tiksinmenin Aracı Rollerinin Değerlendirilmesi

“…It has been shown that pandemic-related stress has effects on symptom exacerbation (Abba-Aji et al, 2020). Mazhar, Khaliq, & Arshad (2021) also reported results regarding sudden symptom onset. In this respect, OCD becomes a very important phenomenon in the context of the pandemic.…”

“…Abba-Aji ve arkadaşları (2020), toplum temelli çalışmalarında katılımcıların %53,8'inin (n=2771), COVID-19 salgını sırasında ellerini yıkamakla ilgili katı kurallar hissetiktiklerini, %60,3'ünün (n=3111), OKB semptomlarının başladığını bildirmiştir. Mazhar, Khaliq ve Arshad (2021), bir başka çalışmada sağlık öğrencileri ile çalışmış; öğrencilerin %75'inin (n = 497) pandemi sırasında OKB skorunda kötüleşme yaşarken; %25'inin (n = 176) pandemi sırasında yeni başlayan OKB semptomolojisi geliştirdiğini raporlamışlardır.…”