Coping strategies in obsessive-compulsive patients during Covid-19 lockdown

Prevalence and associated factors of obsessive compulsive symptoms among under graduate medical and health science students in Dilla university, Ethiopia: a cross-sectional study

BACKGROUND

Obsessive-Compulsive Disorder (OCD) is a debilitating mental health condition characterized by recurrent, intrusive thoughts and repetitive behaviors that significantly disrupt daily life. Medical students may be uniquely susceptible to obsessive compulsive symptoms due to their constant exposure to potential contaminants and infectious diseases during their training. Obsessive Compulsive symptoms among medical students are often overlooked, which can significantly impact their academic performance, well-being, and future career prospects. The prevalence and factors of obsessive compulsive symptom is not widely studied in low and middle income countries and there are limited studies in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of obsessive compulsive symptoms among medical students.

METHODS

This was a cross-sectional study conducted among 370 students. The outcome variable was assessed using the Obsessive-Compulsive Inventory-Revised scale (OCI-R). The collected data were entered using kobo collect tool box version 1.3 and analyzed using SPSS version 25. Bivariable and multivariable logistic analysis was conducted to identify factors associated with Obsessive Compulsive symptoms and variables with P-values less than 0.05 were considered to have significant association with 95% confidence interval.

RESULT

The probable prevalence of obsessive-compulsive disorder among medical and health science students was 28% with (95% CI: 26.4-32.7). Being female [AOR = 1.33(95%CI: 1.09, 2.18)], Depressive symptoms [AOR = 2.12(95%CI: 1.95, 4.06)], Maladaptive coping mechanism [AOR = 1.74 (95%CI: 1.23, 2.50)], and Poor sleep quality [(AOR = 1.48(95%CI: 1.08, 2.24)] were significantly associated with obsessive compulsive symptoms.

CONCLUSION

Obsessive Compulsive Symptom has a high probable prevalence among medical and health science students. Being female, experiencing depressive symptoms, employing maladaptive coping mechanisms, and having poor sleep quality were significantly associated with obsessive-compulsive disorder. Therefore, early detection, screening, and appropriate intervention for obsessive-compulsive symptoms in medical students are crucial.

The long-term impact of the covid-19 pandemic on patients with obsessive-compulsive disorder

We investigated how patients with obsessive-compulsive disorder (OCD) were affected by coronavirus disease of 2019 (COVID-19)-related stress over the long term compared to healthy individuals. We explored how the pandemic affected changes in obsessive-compulsive symptoms and their contributing factors. The study included 100 patients with OCD and 100 sex-matched healthy controls whose sociodemographic and clinical information were gathered. Participants in the study were recruited between December 2021 and May 2022 from individuals attending to the outpatient clinics of the University Department of Psychiatry. The Depression Anxiety Stress Scale-21, Perceptions and Attitudes Towards COVID-19 Questionnaire, COVID-19 Compliance with Prevention Measures Scale, and COVID-19 Stress Scale were used in this study. Patients were assessed using the Yale-Brown Obsession Compulsion Scale based on their conditions before and during the pandemic. Patients with OCD perceived COVID-19 disease as more dangerous and contagious (respectively P = .01, P = .01) compared to the controls. Fifty percent of the patients with OCD experienced an increase in symptoms. Disease severity was increased in mild and moderate OCD, while no significant change was found in severe OCD. Perceiving COVID-19 disease as more dangerous (P = .031), COVID-19-related traumatic stress (P = .013), compulsive control (P = .022), xenophobia (P = .005), and COVID-19-related thoughts (P = .008) were more frequent in OCD patients with clinical worsening. In regression analysis, younger age (OR: 0.95, 95% CI (0.91-0.99)) and higher levels of COVID-19-related stress (OR: 1.03 95% CI (1.01-1.05)) are associated with worsening OCD symptoms. Patients with OCD were adversely affected by the COVID-19 pandemic. Close monitoring of patients with OCD during the pandemic is recommended.

Relationship between coping strategies and change in symptom severity in contamination-focused OCD patients during the COVID-19: a one-year follow-up

OBJECTIVE

To examine the relationship between coping strategies and the change in symptom severity in contamination-focused OCD patients during the COVID-19 pandemic over a one-year follow-up.

METHODS

In March 2020, a one-year follow-up study was initiated with 56 contamination-focused OCD patients in Turkey. Coping strategies were evaluated using the COPE scale. OCD symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at the beginning and end of the year. The Fear of COVID-19 Scale was administered mid-year.

RESULTS

One year post the onset of COVID-19, 68% of patients showed increased OCD symptom severity, while 32% displayed a decrease. Higher scores on the fear of COVID-19 scale and lower acceptance scores from COPE subscales were correlated with increased OCD symptom severity.

CONCLUSIONS

The COVID-19 pandemic has intensified OCD symptoms in a substantial proportion of patients, particularly those with heightened fears related to the pandemic, and reduced acceptance-based coping strategies. Tailored interventions emphasising adaptive coping mechanisms may benefit OCD patients in managing their symptoms during external stressors like pandemics.

Obsessive compulsive disorder: overview of the condition and its nursing management

Obsessive compulsive disorder (OCD) is a complex condition characterised by intrusive and distressing thoughts (obsessions) and repetitive behaviours or mental acts (compulsions). The symptoms of OCD cause significant distress and anxiety and can have a debilitating effect on a person's daily functioning. This article gives an overview of OCD, including its prevalence, aetiology, symptoms and treatment strategies, with the aim of enhancing nurses' understanding of the condition and its adverse effects on a person's life. The author also discusses some of the ways in which nurses in any setting can support a person with OCD.

From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context

When "hijacked" by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in the dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain correlate of mental health, dopamine has a central functional role in behavioral regulation from healthy reward-seeking to pathological adaptation to stress in response to adversity. This narrative review offers a spotlight view of the transition from healthy reward function, under the control of dopamine, to the progressive deregulation of this function in interactions with other brain centers and circuits, producing what may be called an anti-reward brain state. How such deregulation is linked to specific health-relevant behaviors is then explained and linked to pandemic-related adversities and the stresses they engendered. The long lockdown periods where people in social isolation had to rely on drink, food, and digital rewards via the internet may be seen as the major triggers of changes in motivation and reward-seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain is discussed. It is argued that, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior changes and mental health is affected, depending on individual vulnerabilities. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

Early maladaptive schemas and obsessive-compulsive disorder: A systematic review and meta-analysis

BACKGROUND

Obsessive-compulsive disorder (OCD) is a condition with poor treatment outcomes. Improved understanding of the aetiology can inform prevention and treatment approaches; hence several studies have assessed early maladaptive schemas (EMSs) in OCD. This systematic review and meta-analysis aimed to synthesise the evidence on relationships between the 18 EMSs and OCD.

METHODS

The study was conducted according to PRISMA guidelines and registered on PROSPERO (CRD42022329337). A systematic search of PubMed, PsycINFO, and CINAHL Complete was conducted on 4 June 2022. Studies in peer-reviewed journal articles were included if they assessed EMSs and OCD (diagnosis or symptom severity) in adults with a mean age of 18 years or older. Studies were excluded if they were not in English, did not include original quantitative data, or reported on case studies. Study details were tabulated and the meta-analysis findings were presented using forest plots. Methodological quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS).

RESULTS

Based on 22 studies (pooled N = 3699), all 18 EMSs were positively correlated with OCD. The largest associations were with the dependence/incompetence (r = 0.40 95 % CI [0.32, 0.47]), vulnerability to harm or illness (r = 0.40 95 % CI [0.32, 0.48]), and negativity/pessimism schemas (r = 0.42 95 % CI [0.22, 0.58]).

LIMITATIONS

Several meta-analyses showed considerable heterogeneity and publication bias.

CONCLUSIONS

The findings suggest all EMSs, particularly those relating to disproportionate negative expectations and a perceived inability to cope, are implicated in OCD. Psychological prevention and treatment for OCD may benefit from targeting these schemas.

Longitudinal Course of Obsessive-Compulsive Symptoms During the Covid-19 Pandemic: A Systematic Review of Three Years of Prospective Cohort Studies

Objective

During the pandemic, there has been a slight increase in obsessive-compulsive symptoms in both clinical and non-clinical samples. Three years after the pandemic, we conducted the first systematic review of prospective cohort studies assessing temporal changes in obsessive-compulsive symptoms and their extent in both patients with obsessive-compulsive disorder (OCD) and community samples, regardless of age or socio-cultural background, during any phase of the pandemic.

Method

Prospective cohort studies were included if validated self-report questionnaires or standardized interviews for obsessive-compulsive symptoms were used. Studies that enrolled OCD patients were included if OCD was diagnosed before the outbreak of the pandemic. The following were our exclusion criteria: cross-sectional and case-control studies, single case studies, editorials, commentaries, and reviews. Studies assessing the effectiveness of an intervention were excluded.

Results

15 studies were included. Overall, studies showed a small upsurge in obsessive-compulsive symptoms, especially washing/contamination symptoms, during the coronavirus outbreak. The severity of symptoms seemed to follow the pattern of restriction measures and the increase in the number of COVID-19 cases.

Conclusions

Factors contributing to the worsening of obsessive-compulsive symptoms during the pandemic were discussed.

Severity and Changes in OCD Dimensions during COVID-19: A Two-Year Longitudinal Study

BACKGROUND

The COVID-19 pandemic appears to be associated with a worsening of obsessive-compulsive symptoms in both young people and adults with OCD and it is necessary to analyze the variables involved in this worsening over time. The main aim of this study was to examine long-term changes in total severity and obsessive-compulsive dimensions in obsessive-compulsive patients during the COVID-19 pandemic.

METHOD

A total 250 OCD patients were selected from various associations, clinical centers and hospitals. We discarded 75 as they did not meet the inclusion criteria. A total of 175 obsessive-compulsive participants aged between 16 and 58 years old (M = 33.33, SD = 9.42) were evaluated in obsessive-compulsive symptom severity and dimensions OCD assessed using the Y-BOCS and D-YBOCS scales in T1 (April-June 2020) and in T2 (March-April 2022). The evaluation was carried out through an online survey and face-to-face with a professional clinician at both time points.

RESULTS

Intragroup differences in severity were observed, reaching higher scores for patients with contamination, somatic, aggressive and religious. Some patients changed their main dimension, increasing the percentage of patients with contamination and somatic obsessions.

CONCLUSIONS

COVID-19 was associated with both changes in severity and also affected some dimensions more than others, particularly those related to the virus itself (contamination and somatic).

The development of compulsive coping behaviour is associated with a downregulation of Arc in a Locus Coeruleus neuronal ensemble

Some compulsive disorders have been considered to stem from the loss of control over coping strategies, such as displacement. However, the cellular mechanisms involved in the acquisition of coping behaviours and their subsequent compulsive manifestation in vulnerable individuals have not been elucidated. Considering the role of the locus coeruleus (LC) noradrenaline-dependent system in stress and related excessive behaviours, we hypothesised that neuroplastic changes in the LC may be associated with the acquisition of an adjunctive polydipsic water drinking, a prototypical displacement behaviour, and the ensuing development of compulsion in vulnerable individuals. Thus, male Sprague Dawley rats were characterised for their tendency, or not, to develop compulsive polydipsic drinking in a schedule-induced polydipsia (SIP) procedure before their fresh brains were harvested. A new quantification tool for RNAscope assays revealed that the development of compulsive adjunctive behaviour was associated with a low mRNA copy number of the plasticity marker Arc in the LC which appeared to be driven by specific adaptations in an ensemble of tyrosine hydroxylase (TH)+, zif268- neurons. This ensemble was specifically engaged by the expression of compulsive adjunctive behaviour, not by stress, because its functional recruitment was not observed in individuals that no longer had access to the water bottle before sacrifice, while it consistently correlated with the levels of polydipsic water drinking only when it had become compulsive. Together these findings suggest that downregulation of Arc mRNA levels in a population of a TH+/zif268- LC neurons represents a signature of the tendency to develop compulsive coping behaviours.

Psychometric properties of the BALCI Turkish version

The present study aimed to adapt and validate the Beliefs About Losing Control Inventory (BALCI) in the non-clinical Turkish emerging adults sample. The study group consisted of 549 participants from three study phases and aged between 18 and 28 years and mainly women. According to the results of the confirmatory factor analysis (CFA), the BALCI Turkish Version (BALCI-TV) confirmed 21 items in three factors. The network analysis findings showed that the items including the factors were together. The results indicated that configural, metric, scalar, and strict invariance across the gender. Cronbach's α and McDonald's ω of the total BALCI-TV were .90. Test-retest correlation result was .89. All results indicated that the BALCI-TV had good psychometric properties. The BALCI-TV can be provided to measure control and beliefs related to control within obsessive-compulsive disorder for Turkish academics and mental health practitioners.

Turning to Religion During COVID-19 (Part II): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship between Religious Coping and Mental Health throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: Part I discussed the positive mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023), while this Part II discusses negative mental health indicators. A systematic review of the databases of Science Direct, EBSCO, Cochrane, PubMed, and Google Scholar identified 33 articles related to the severity of depressive symptoms: 30 to anxiety, 23 to stress, 1 related to PTSD symptoms and peritraumatic stress, and 5 related to general negative mental health. The limitations of the research as well as further directions for exploration are discussed.Clinical trial registration This Review was pre-registered at OSF: osf.io/54ygr ( https://doi.org/10.17605/OSF.IO/GMNFV ).

Turning to Religion During COVID-19 (Part I): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship Between Religious Coping and Mental Health Throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: this first part discusses positive mental health indicators, while the second discusses negative mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023). A systematic review of PubMed, Science Direct, the Cochrane Library, Google Scholar, the Database of Abstracts of Reviews of Effects, and Google Scholar databases was carried out. In addition to the synthesis of information obtained from the research, a meta-analysis of correlation was also performed to determine the strengths of the relationships between the analysed variables, and selected moderators were assessed using meta-regression. Quality of life, well-being, satisfaction with life, happiness, and post-traumatic growth were the positive mental health indicators considered. Meta-analyses indicated a statistically significant relationship between positive religious coping and flourishing (well-being) with overall correlation values of 0.35 [0.30; 0.40]. Further calculations also indicated a relationship between negative religious coping and flourishing - 0.25 [- 0.34; - 0.15]. Data synthesis shows associations between religious coping and such indicators as satisfaction with life and post-traumatic growth, but these issues require further investigation.

Obsessive-Compulsive Disorder During the COVID-19 Pandemic Process: A Narrative Review

This study aimed to review all empirical contributions published between March 2020 and June 2022, addressing the impact of the COVID-19 pandemic on obsessive-compulsive disorder in adults. We searched the literature in PubMed, Google Scholar, and Web of Science. A total of 543 articles were scanned and 73 full-text articles were identified. Reviews, comments, letters to the editor, and case reports (except case series) were excluded. It was determined that 42 articles met the inclusion criteria, 6 studies involving only children and adolescents were excluded, and 36 were decided on their suitability for our study. The analysis determined that COVID-19 had an impact on obsessive-compulsive disorder. Characteristics such as liability for harm and unacceptable thoughts influenced the symptoms as well as contamination and washing. Some studies showed an increase in the severity of obsessive-compulsive symptoms, while some reported no worsening but improvement with treatment and follow-up. While some reported variations in outcomes related to sociodemographic characteristics and subtypes, some focused on the risk of suicide. There were also studies conducted on special groups such as pregnant women or healthcare workers. The results were controversial. While available data contain more information on worsening obsessive-compulsive disorder symptoms, data on the status of patients under treatment were scarce. There were not enough studies evaluating follow-up results. Influencing factors such as sociodemographic characteristics, subtypes, comorbid conditions, treatment, and support did not seem to have been adequately addressed.

Psychometric Analysis of the Quarantine Coping Strategies Scale (Q-COPE) in the Spanish Language

The possibility of facing an epidemic or pandemic resulting in mandatory isolation or quarantine has become a relevant construct for comparing and evaluating coping strategies under such conditions. The objective of this research was to develop and analyze the psychometric properties of a scale to assess quarantine coping strategies (Q-COPE). This was an instrumental study and 1110 Peruvian adults (M = 26.9 years; SD = 9.77) participated in the context of social isolation. For the construction of the scale, qualitative and quantitative procedures were followed. The internal structure was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The content analysis by expert judges supports the representativeness of the items related to the construct. EFA and CFA allowed the establishment of five factors: Emotional regulation, Information, Accommodation, Social support, and Altruism. The first-order model presents adequate goodness-of-fit indices: χ² = 489.048, df = 220, χ²/df = 2.223, SRMR = 0.025, CFI = 0.969, TLI = 0.965, RMSEA = 0.047. Likewise, the second order model presented similar values: χ² = 499.674, df = 225, χ²/df = 2.221, SRMR = 0.026, CFI = 0.969, TLI = 0.965, RMSEA = 0.047. The 23-item version was consistent with the proposed theory, obtained adequate fit indices and acceptable factor loadings (>0.70), and presented good internal consistency indexes evaluated by Cronbach's α, ordinal α, omega (ω), and H coefficient. It is concluded that the Q-COPE scale presents good psychometric properties that justify its use in an adult population and allows the assessment of the coping strategies that people use in the face of a quarantine situation.

Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder

The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress.

Mindfulness-based psychotherapy in patients with obsessive-compulsive disorder: A meta-analytical Study

Background/Objective

Obsessive compulsive disorder is a disorder of special relevance in mental health, however, not all patients respond adequately to traditional intervention systems. The present work aims to study the usefulness of mindfulness-based interventions in patients with obsessive compulsive disorder.

Method

An exhaustive search of the literature between 1996 and 2021 allowed us to locate 11 published articles. The effect size was the pretest-posttest standardized mean change calculated for obsession-compulsion, as well as depression symptoms and conscious coping.

Results

he results showed mean effect sizes for mindfulness in the reduction of obsessive-compulsive symptoms (d + = 0.648) and, to a lesser extent, depression (d + = 0.417) and the improvement in Mindfull coping (d + = 0.509). There was no significant decrease in effect size when mindfulness was applied in patients with residual symptoms from previous treatments.

Conclusions

These results are promising regarding the usefulness of the application of intervention programs based on mindfulness in people with obsessive compulsive disorder, both as an alternative option and as a complementary treatment to more traditional intervention formats.

Hand Washing: When Ritual Behavior Protects! Obsessive-Compulsive Symptoms in Young People during the COVID-19 Pandemic: A Narrative Review

The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive–compulsive (OC) symptoms in this population. OC symptoms are widespread in the general population, with varying degrees of intensity. At their most extreme, they manifest in obsessive–compulsive disorder (OCD), which is characterized by obsessive thoughts and compulsive behaviors. The present narrative review aimed at evaluating the relationship between the COVID-19 pandemic and OCD and OC symptoms in young people, especially children and adolescents with and without OCD, focusing on vulnerability and risk factors and the impact of lockdown measures. Of the six studies identified, four examined clinical samples diagnosed with OCD and two looked at community-based adolescent samples. Five of the six studies found that OC symptoms increased during the pandemic. Additionally, vulnerability to anxiety may constitute a risk condition and the lockdown measures and personal stressful life events can constitute potential triggers of OC symptoms, while ongoing treatment for OCD had a protective effect. The results suggest that, during the COVID-19 pandemic, obsessive and compulsive behavior (e.g., hand washing) in young people at the greatest risk should be monitored, and the intervention of mental health services should be maintained. More research is needed in this area.

An international study on psychological coping during COVID-19: Towards a meaning-centered coping style

BACKGROUND/OBJECTIVE

This study examined the role of different psychological coping mechanisms in mental and physical health during the initial phases of the COVID-19 crisis with an emphasis on meaning-centered coping.

METHOD

A total of 11,227 people from 30 countries across all continents participated in the study and completed measures of psychological distress (depression, stress, and anxiety), loneliness, well-being, and physical health, together with measures of problem-focused and emotion-focused coping, and a measure called the Meaning-centered Coping Scale (MCCS) that was developed in the present study. Validation analyses of the MCCS were performed in all countries, and data were assessed by multilevel modeling (MLM).

RESULTS

The MCCS showed a robust one-factor structure in 30 countries with good test-retest, concurrent and divergent validity results. MLM analyses showed mixed results regarding emotion and problem-focused coping strategies. However, the MCCS was the strongest positive predictor of physical and mental health among all coping strategies, independently of demographic characteristics and country-level variables.

CONCLUSIONS

The findings suggest that the MCCS is a valid measure to assess meaning-centered coping. The results also call for policies promoting effective coping to mitigate collective suffering during the pandemic.

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

BACKGROUND

The 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.

METHODS

We 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.

RESULTS

A 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.

CONCLUSION

This 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.

The associations of obsessive-compulsive symptom dimensions and general severity with suicidal ideation in patients with obsessive-compulsive disorder: The role of specific stress responses to COVID-19

Suicidal ideation is prevalent in patients with obsessive-compulsive disorder (OCD); but, during COVID-19, it may be increased. The present study aimed to examine the effects of obsessive-compulsive (OC) symptom dimensions and OCD severity on suicidal ideation by considering the role of stress responses in reaction to COVID-19 in a clinical sample of patients with OCD. In a cross-sectional study, 304 patients with OCD completed measures of OC symptom dimensions, OCD severity, general mental health (depression and anxiety), and COVID-19-related stress. Results showed that after controlling for depression, anxiety, comorbidity, and lifetime suicide attempts, the OC symptom dimensions of responsibility for harm and unacceptable obsessional thoughts as well as general severity had indirect effects on suicidal ideation through the specific stress responses to COVID-19, including traumatic stress and compulsive checking. The study shows that OCD patients with specific OC symptom dimensions and severe OCD are more likely to have suicidal ideation during the pandemic. Further, the specific stress responses to COVID-19 may be an underlying mechanism. Clinicians should carefully assess suicidal ideation in patients with OCD who experience responsibility for harm and unacceptable thoughts, particularly during the pandemic.

A Reliability Generalization Meta-analysis of the Padua Inventory-Revised (PI-R)

Background/Objective: The Padua Inventory-Revised (PI-R) is a widely applied instrument to measure obsessive-compulsive symptoms in clinical and nonclinical samples. We conducted a reliability generalization meta-analysis on the PI-R. Method: An exhaustive literature search yielded 118 empirical studies that had applied the PI-R, from which 30 studies (33 samples) reported an original reliability estimate. Results: Assuming a random-effects model, the average internal consistency reliability (Cronbach's alpha) was .92 (95% CI [.91, .93]) for the total scores, and ranged from .74 to .89 for the subscales. Assuming mixed-effects models, moderator analyses showed a positive statistically significant association between the standard deviation of the total scores and the reliability coefficients (p = .002; R² = .38). Conclusions: In terms of reliability, the PI-R scale was found to be adequate for both research and clinical purposes, although exhibiting large heterogeneity across studies. Future empirical studies using the PI-R should be required to provide at least one reliability estimate based on their own data.

Obsessive-Compulsive Disorder During the COVID-19 Pandemic: a Systematic Review

PURPOSE OF REVIEW

This systematic review evaluated the impact of the COVID-19 pandemic on obsessive-compulsive symptoms.

RECENT FINDINGS

Most studies showed that obsessive-compulsive symptoms worsened during the early stages of the pandemic, particularly for individuals with contamination-related obsessive-compulsive disorder (OCD), though other symptoms dimensions were found to worsen as well. Many patients and individuals in the general population experienced new obsessive-compulsive-like symptoms centered on COVID-19. Self-reported rates of symptom exacerbation and COVID-19-focused symptoms were consistently lower in studies that recruited patients from specialty clinics (compared to online samples). Most studies were conducted in Spring/Summer, 2020. The COVID-19 pandemic has been an enormous stressor for individuals with OCD, especially for those with contamination symptoms. Regardless, there is strong reason to believe gold standard treatment approaches for OCD have maintained strong efficacy. Disseminating and effectively delivering evidence-based treatments for OCD is an urgent public health priority.

Investigating the Association Between Obsessive-Compulsive Disorder Symptom Subtypes and Health Anxiety as Impacted by the COVID-19 Pandemic: A Cross-Sectional Study

Background

Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD.

Methods

A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure.

Results

Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). Canonical correlation analyses revealed significant associations between the OCI-R subscales and COVID-19 Impact measure, F (12, 490) = 8.14, p = 0.001, and the SHAI subscales with the COVID-19 Impact Measure, F (4, 498) = 8.18, p = 0.001). Specifically, washing and checking OCI-R subscales correlated with both components of the COVID-19 Impact measure, as did the health anxiety and beliefs SHAI subscales. Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD.

Discussion

Contamination and checking OCD subtypes have been associated with increased hand-washing behaviour and avoidance of distress-inducing cues. Consideration should be given to targeted support tailored to patients with these subtypes of OCD.

Coping Strategies, Anxiety and Depression in OCD and Schizophrenia: Changes during COVID-19

BACKGROUND

The main aim was to examine changes in coping strategies, anxiety and depression in obsessive-compulsive and schizophrenia patients during COVID-19, in addition to controlling the influence of intolerance to uncertainty and experiential avoidance.

METHOD

The first time, the study comprised (15-30 April 2020) 293 patients, 113 of whom were diagnosed with obsessive-compulsive disorder, 61 with schizophrenia and 119 healthy controls, aged 13-77 years (M = 37.89, SD = 12.65). The second time (15-30 November), the study comprised 195 participants (85 obsessive-compulsive patients, 42 schizophrenic patiens and 77 healthy controls participants). The evaluation was carried out through an online survey.

RESULTS

The clinical groups worsened over time in cognitive coping, anxiety and depression, while the control group only worsened in depression. Intergroup differences in anxiety, depression and coping strategies were maintained, highlighting the use of some maladaptive strategies (avoidance, spiritual) in clinical groups. Experiential avoidance and tolerance for uncertainty mainly affected coping.

CONCLUSIONS

The duration of COVID-19 not only produced changes in anxiety and depression in clinical groups but also in coping strategies to face this pandemic and its consequences.

Variation in Obsessive-Compulsive Disorder Symptoms and Treatments: A Side Effect of COVID-19

The Coronavirus Disease 2019 (COVID-19) exerts variable impact on patients with obsessive compulsive disorders (OCD). There remains a challenge to determine the extent to which OCD is exacerbated due to the pandemic. Therefore, our aim is to explicate the latest researching progress of OCD under COVID-19 based on a review of 15 existing articles. Our review confirms the prevalence of OCD exacerbation in different age groups and particular symptoms. However, it also reveals nonconformity among research, lack of investigation in OCD treatment, and imbalance in OCD symptoms research. Further, we discuss the probable reasons of the exacerbation and current situation of OCD treatments. Finally, based on our discussion, we offer suggestions on how to manage OCD under the new circumstance, including the introduction of new policies, the use of communications technology, the improvement of researching methods, and possible angles for further research.