Individuals with obsessive compulsive disorder (OCD) were at an increased risk for negative effects due to the novel coronavirus 2019 (COVID-19) pandemic. These findings were published in the Journal of Anxiety Disorders.
Individuals (N=394) with OCD were recruited between March 23 and May 18, 2020 through the German Society for Obsessive Compulsive Disorders to participate in a survey. At that time, most of Germany was under restricted social contact orders. Participants were assessed by the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), and a newly derived COVID-19-specific assessment of OCD symptoms.
Survey respondents were aged mean 37.76 (standard deviation [SD], 12.14) years and were mostly women (n=291) with an average illness duration of 17.40 (SD, 12.46) years. The mean OCI-R score was 27.64 (SD, 11.47) and the mean PHQ-9 score was 12.41 (SD, 6.61). Participants had primary symptoms of obsessions (66.2%), washing (56.6%), checking (50%), ordering (15.7%), and hoarding (5.6%).
Most individuals with OCD (71.8%) reported an exacerbation of their OCD symptom severity, while 21.7% did not observe a change to their symptoms, and 6.5% thought their symptoms had decreased during the COVID-19 restrictions.
OCI-R scores were correlated with small to medium magnitude OCD severity (r, .268; P <.001), compulsions (r, .304; P <.001), avoidance (r, .208; P <.001), and obsessions (r, .270; P <.001).
The investigators separated the respondents on the basis of washing (n=223) and non-washing (n=171) symptoms.
Washers had elevated OCI-R scores (mean, 29.82; SD, 11.06) compared with non-washers (mean, 24.80; SD, 11.39; P <.001). Washers were more likely to report a negative change to their OCD symptoms (t, 2.385; P =.018), compulsions (t[385.4], 3.523; P <.001), and avoidance behaviors (t, 4.571; P =.001).
These observed differences were reported to be due to the availability of cleaning products (t[385.9], 6.485; P <.001) economic factors (t[331.9], 2.687; P =.008), and interpersonal conflicts (t[389.7], 3.859; P <.001). The most common motivations for the observed changes to their OCD symptoms were cited as an increased fear due to COVID-19 (48.32%) and the fact that others now realized how dangerous viruses can be (36.95%).
This study may have been limited by the self-reported design. OCD has been associated with a high prevalence of hidden symptoms as many individuals with OCD feel shame, which may have led to some under reporting.
These data indicated that people with OCD were at an increased risk for worsening symptoms during the global COVID-19 pandemic. Individuals with obsessive washing were at particular risk for experiencing an increase of OCD symptoms. These responses highlighted the need for easy access to therapeutic interventions for individuals with OCD such that lasting consequences from the pandemic may be avoided.
Jelinek L, Moritz S, Miegel F, Voderholzer, U. Obsessive-compulsive disorder during COVID-19: Turning a problem into an opportunity? J Anxiety Disord. 2020;77:102329. doi: 10.1016/j.janxdis.2020.102329