Obsessive-Compulsive Disorder During the COVID-19 Pandemic—A Systematic Review

Abstract

BackgroundThe COVID-19 pandemic and its associated restrictions may contribute to a deterioration in mental health; individuals with obsessive-compulsive disorder (OCD) may be particularly affected. This systematic review aimed to investigate the effects of the current pandemic on people diagnosed with OCD, and whether pandemics may affect the development of OCD symptoms.MethodsWe conducted a systematic search using NCBI PubMed, SCOPUS, and Google Scholar on February 9, 2021. Research articles related to OCD and COVID-19 or other pandemics were attempted to be identified using pre-defined search terms. Case reports, clinical guidelines, letters, and clinical research articles including ≥100 participants were included; reviews were excluded. The systematic review adheres to PRISMA guidelines and the Newcastle-Ottawa Scale was used to assess the quality of the included clinical research articles.ResultsA total of 79 articles were included in the full-text assessment. Of these, 59 were clinical research articles, two were clinical guidelines, six were case reports, and 12 were letters. The research articles examined OCD symptoms in adult patients with diagnosed OCD, the general population, pregnant women, healthcare workers, students, and young adults, children, and adolescents. Only one study on OCD in previous pandemics was identified.ConclusionThis systematic review found that people both with and without diagnosed OCD prior to the pandemic generally experienced a worsened landscape of symptoms of OCD during the COVID-19 pandemic. However, the responses are heterogeneous and many factors other than the pandemic seemed to affect the development of OCD symptoms. To prevent the impairment of symptoms and the development of new cases, close monitoring of patients with OCD and education of the general public is essential. Literature is still limited; thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.

Changes in contamination-related obsessions and compulsions during the COVID-19 pandemic: A Norwegian longitudinal study

“…The literature on the pandemic's impact on OCS is already quite extensive, including five narrative or systematic reviews: Zaccari et al (2021 , k = 14), Liu et al (2021 , k = 13), Guzick et al (2021 , k = 67), Grant et al (2022 , k = 32), and Linde et al (2022 , k = 79). Whereas the first two reviews had a narrower scope (e.g., considered only clinical samples), the latter three reviews examined OCS in general population samples and individuals with OCD during the pandemic, including both cross-sectional and longitudinal studies.…”

“…Whereas the first two reviews had a narrower scope (e.g., considered only clinical samples), the latter three reviews examined OCS in general population samples and individuals with OCD during the pandemic, including both cross-sectional and longitudinal studies. Based on their literature reviews, all three ( Guzick et al, 2021 ; Grant et al, 2022 ; Linde et al, 2022 ) argued that most (but not all) studies reported a worsening of OCS during the early stages (i.e., spring/summer 2020) of the pandemic, both in the general population and in individuals with OCD. However, the pandemic's degree of impact on OCS severity and course varied greatly between studies.…”

“…Although increasing mental health symptoms following major life stressors, such as the pandemic, are common, most people experience a recovery in distress in the longer term (e.g., Galatzer-Levy et al, 2018 ; Robinson et al, 2021 ). A limitation to the literature examining the pandemic's impact on OCS severity and course is that most of the research is cross-sectional in nature (76% of studies in the review by Linde et al, 2022 ) and/or conducted in the first months of the pandemic (spring/summer 2020). Consequently, we know little about the long-term trajectories of these symptoms.…”

COVID-19 vaccination coverage among patients with psychiatric disorders in China during the pandemic: a cross-sectional study

“…Previous studies have shown that SARS-CoV-2 infection increases the risk of anxiety and stress-related disorders, such as post-traumatic stress disorder (PTSD), leading to exacerbation of other psychiatric illnesses, including depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder (OCD), substance abuse, and long-term cognitive decline [8][9][10][11][12][13][14]. Current studies have revealed high prevalence of depressive, anxiety, acute stress symptoms and increased COVID-19 related self-harm or suicidality in individuals with mental illness as well as an increased burden of nursing among their family members after the COVID-19 outbreak [15][16][17][18].…”

Development of the COVID-19-Specific Obsessive Compulsive Symptoms Scale with Various Validity and Reliability Proofs

“…Obsessive-compulsive disorder (OCD) is one of the key mental health problems most affected by fear of COVID-19 (Guzick et al, 2021;Linde et al, 2022). According to the American Psychiatric Association, OCD is characterized by obsessions and compulsions.…”