How is COVID-19 affecting patients with obsessive–compulsive disorder? A longitudinal study on the initial phase of the pandemic in a Spanish cohort

Abstract

Background: Although the consequences of the COVID-19 pandemic on emotional health are evident, little is known about its impact on patients with obsessive-compulsive disorder (OCD).Methods: 127 patients with OCD who attended a specialist OCD Clinic in Barcelona, Spain, were assessed by phone from April 27 to May 25, 2020, during the early phase of the pandemic, using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a structured interview that collected clinical and sociodemographic information. Results were compared with those for 237 healthy controls from the same geographic area who completed an online survey.Results: Although 65.3% of the patients with OCD described a worsening of their symptoms, only 31.4% had Y-BOCS scores that increased >25%. The risk of getting infected by SARS-CoV2 was reported as a new obsession by 44.8%, but this only became the main obsessive concern in approximately 10% of the patients. Suicide-related thoughts were more frequent among the OCD cohort than among healthy controls. The presence of pre-pandemic depression, higher Y-BOCS scores, contamination/washing symptoms, and lower perceived social support all predicted a significantly increased risk of OCD worsening. Conclusions:Most patients with OCD appear to be capable of coping with the emotional stress of the COVID-19 outbreak and its consequences during the initial phase of the pandemic. Nevertheless, the current crisis constitutes a risk factor for a significant worsening of symptoms and suicidal ideation. Action is needed to ensure effective and individualized follow-up care for patients with OCD in the COVID-19 era.

Cognitive Training via a Mobile Application to Reduce Obsessive-Compulsive-Related Distress and Cognitions During the COVID-19 Outbreaks: A Randomized Controlled Trial Using a Subclinical Cohort

“…Fear of infection, germs, contamination, and cleaning compulsions are some of the most frequently reported OCD symptoms ( Abramowitz et al, 2010 , Cordeiro et al, 2015 ). Recent empirical evidence suggests that the onset of the COVID-19 pandemic has been a significant stressor for individuals with OCD and has been associated with increased severity of obsessions and compulsions, particularly, for those with pre-existing contamination symptoms ( Alonso et al, 2021 , Benatti et al, 2020 , Guzick et al, 2021 , Jelinek et al, 2021 , Tanir et al, 2020 ). For instance, several studies have shown increased frequency of obsessions, time spent on compulsive behaviors, higher reported distress and lower perceived controllability over OCD symptoms in OCD patients during the pandemic ( Alonso et al, 2021 , Jelinek et al, 2021 ).…”

The impact of COVID-19 on patients with OCD: A one-year follow-up study

“…In fact, most [but not all ( Davide et al, 2020 ; Khosravani et al, 2021 )] clinical studies that did not employ a quantitative assessment of SLEs related to the pandemic have also found that the majority of OCD outpatients did not display short-term (<1 year) symptoms deterioration ( Alonso et al, 2021 ; Benatti et al, 2020 ; Carmi et al, 2021 ; Chakraborty and Karmakar, 2020 ; Matsunaga et al, 2020 ; Schwartz-Lifshitz et al, 2020 ; Sharma et al, 2021 ). This is in line with the assumption that people with a previous mental disorder may have more resources to deal with the pandemic, since they chronically experience fear and isolation states in their daily lives ( Florence et al, 2020 ).…”

“… Carmi et al, 2021 ; Davide et al, 2020 )], and to the geographical origin of the study [countries have differed in their lockdown policies and death rates during the pandemic (e.g. Alonso et al, 2021 ; Højgaard et al, 2021 ; Matsunaga et al, 2020 )]. For instance, compared to other regions in the world, Brazil has been known for its inconsistent lockdown policies and, at different moments in the pandemic, one of the world's fastest growing COVID-19 infection rates ( de Souza et al, 2020 )).…”

Viability Study of Machine Learning-Based Prediction of COVID-19 Pandemic Impact in Obsessive-Compulsive Disorder Patients

“…Evidence suggests that people with OCD suffered a substantial impact with the current pandemic ( French and Lyne, 2020 ; Jelinek et al, 2020 ; Alonso et al, 2021 ), especially those with contamination-related and washing-related compulsions ( Fontenelle and Miguel, 2020 ). A recent study by Alonso et al (2021) during the initial (and acute) stage of the lockdown in Spain showed that OCD patients experienced symptoms worsening and the appearance of COVID-19-related obsessions (e.g., fear of getting infected by SARS-CoV2). However, it was also stressed that the majority of the OCD patients (as compared to healthy controls) showed adaptive coping strategies with the emotional distress caused by the lockdown.…”

“…However, it was also stressed that the majority of the OCD patients (as compared to healthy controls) showed adaptive coping strategies with the emotional distress caused by the lockdown. This impact may have been moderated by several socio-emotional variables, such as resilience strategies involving online communication with relatives, physical self-care and adequate financial state ( Alonso et al, 2021 ). It is therefore important to identify those patients at higher risk of worsening symptomatology during the pandemic in order to improve the support provided for such patients in a similar situation in the future.…”