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Jelinek L, Göritz AS, Miegel F, Schuurmans L, Moritz S, Yassari AH, Müller JC. Too much of a good thing? Hand hygiene and the long-term course of contamination-related obsessive-compulsive symptoms. Front Psychol 2024; 15:1279639. [PMID: 38524298 PMCID: PMC10959097 DOI: 10.3389/fpsyg.2024.1279639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/13/2024] [Indexed: 03/26/2024] Open
Abstract
Increased hygiene behavior may be a factor in the development of contamination-related obsessive-compulsive symptoms (C-OCS). We aimed at investigating (1) the course of C-OCS over 1 year after the start of the COVID-19 pandemic and (2) the effects of changes in hand hygiene (i.e., duration and frequency of handwashing) and related distress regulation on the long-term course of C-OCS. In a longitudinal study, we assessed 1,220 individuals from the German general population at the start of the COVID-19 pandemic (t1), 3 months later (t2), and 12 months later (t3). Pre-pandemic data were available in a subsample from 2014 (n = 430). A decrease in C-OCS over the first year of the pandemic emerged with a small effect size. Thirty-six percent of the participants scored above the clinical cut-off score at t1, 31% at t2, and 27% at t3. In 2014, only 11% scored above the clinical cut-off score. Hierarchical regression showed that C-OCS at t1 was the strongest predictor of a long-term increase in C-OCS. With small effect sizes, change in the duration (not frequency) of handwashing from t1 to t2, as well as the distress-reducing effect of handwashing served as additional predictors. Implications for information on hand hygiene guidelines are discussed.
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Affiliation(s)
- Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja S. Göritz
- Behavioral Health Technology, University Augsburg, Augsburg, Germany
| | - Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lea Schuurmans
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amir H. Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Christina Müller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Salmani B, Hasani J, Zanjani Z, Gholami-Fesharaki M. Two Years after the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms. IRANIAN JOURNAL OF PSYCHIATRY 2023; 18:429-442. [PMID: 37881416 PMCID: PMC10593991 DOI: 10.18502/ijps.v18i4.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/15/2022] [Accepted: 01/30/2023] [Indexed: 10/27/2023]
Abstract
Objective: This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM-) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs. Method : In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM- (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses. Results: At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM-. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS. Conclusion: Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.
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Affiliation(s)
- Behzad Salmani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Jafar Hasani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Zahra Zanjani
- Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Jalalifar E, Arad A, Rastkar M, Beheshti R. The COVID-19 pandemic and obsessive-compulsive disorder: a systematic review of comparisons between males and females. Acta Neuropsychiatr 2023; 35:270-291. [PMID: 36861432 DOI: 10.1017/neu.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Coronavirus disease, one of the most disastrous epidemics, has caused a worldwide crisis, and the containment measures applied to decelerate the progression of the pandemic can increase the risk of obsessive-compulsive disorder (OCD). Identifying vulnerable groups in this area can lead us to better resource expenditure, and therefore, this systematic review aims to make a comparison between males and females to determine which of the two groups was most affected by the COVID-19 pandemic regarding OCD. Also, a meta-analysis was designed to investigate the prevalence of OCD during the COVID-19 pandemic. A comprehensive search was conducted among three databases (Medline, Scopus, Web of Science) until August 2021 which resulted in 197 articles, and 24 articles met our inclusion criteria. Overall, more than half of the articles stated the role of gender in OCD during the COVID-19 pandemic. Several articles emphasized the role of the female gender, and some others the role of the male gender. The meta-analysis revealed a 41.2% overall prevalence of OCD during the COVID pandemic and 47.1% and 39.1% OCD prevalence for female and male genders respectively. However, the difference between the two genders was not statistically significant. Generally, it seems that females are at greater risk of OCD during the COVID-19 pandemic. In the following groups, the female gender may have acted as a risk factor: under-18 years students, hospital staff, and the studies in the Middle East. In none of the categories, male gender was clearly identified as a risk factor.
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Affiliation(s)
- Erfan Jalalifar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirreza Arad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Rastkar
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasa Beheshti
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
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Rosa-Alcázar Á, Parada-Navas JL, García-Hernández MD, Pozza A, Tondi P, Rosa-Alcázar AI. Severity and Changes in OCD Dimensions during COVID-19: A Two-Year Longitudinal Study. Brain Sci 2023; 13:1151. [PMID: 37626507 PMCID: PMC10452262 DOI: 10.3390/brainsci13081151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
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).
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Affiliation(s)
- Ángel Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | | | - Maria Dolores García-Hernández
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | - Andrea Pozza
- Department of Medical, Surgical and Neuroscience Sciences, University of Siena, 53100 Siena, Italy;
| | - Paolo Tondi
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | - Ana Isabel Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
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Sileo KM, Luttinen R, Muñoz S, Hill TD. Gender Role Discrepancy Stress and COVID-19 Prevention Behaviors Among Men in the United States. Am J Health Promot 2023; 37:766-777. [PMID: 36648009 PMCID: PMC9852979 DOI: 10.1177/08901171231152140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE To examine the associations between gender role discrepancy (non-conformity to socially prescribed masculine gender role norms) and discrepancy stress (distress arising from this discrepancy) on COVID-19 prevention behaviors among men, and the potential moderating effects of race/ethnicity, sexual orientation, and income on these relationships. DESIGN A national online survey was conducted between May and June 2021. SETTING The United States. SUBJECTS 749 adult men residing in the United States. MEASURES A scale measured gender role discrepancy and discrepancy stress. COVID-19 prevention outcomes were constructed and included self-reported vaccination status/intentions, social distancing, mask-wearing, and hand-sanitizing. ANALYSIS Multivariate generalized linear models were performed in SPSS. RESULTS Gender role discrepancy associated with greater odds of vaccination (AOR = 1.35, 95% CI = 1.02-1.78, P = .04), while discrepancy stress associated with lower odds of vaccination (AOR = .48, 95% CI = .35-.68, P < 0. 001) and mask-wearing (AOR = .54, 95% CI = .37-.79, P = .001) for men overall. Discrepancy stress's negative effect on specific COVID-19 prevention behaviors was only apparent or was amplified for men in lower income brackets (vaccination, social distancing, mask-wearing), racial/ethnic minority men (vaccination), and sexual minority men (social distancing). CONCLUSION This study demonstrates that gender role discrepancy stress negatively affects men's engagement in COVID-19 prevention, particularly for men in marginalized populations.
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Affiliation(s)
- Katelyn M. Sileo
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Rebecca Luttinen
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
- The Department of Demography, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Suyapa Muñoz
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Terrence D. Hill
- The Department of Sociology, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
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Grøtte T, Hagen K, Eid J, Kvale G, le Hellard S, Solem S. Changes in contamination-related obsessions and compulsions during the COVID-19 pandemic: A Norwegian longitudinal study. J Obsessive Compuls Relat Disord 2022; 35:100758. [PMID: 36276590 PMCID: PMC9578966 DOI: 10.1016/j.jocrd.2022.100758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Early stages of the COVID-19 pandemic have been associated with increasing obsessive-compulsive symptoms (OCS), but less is known regarding these symptoms' long-term trajectories. The aim of this study was to examine changes in contamination-related OCS in the Norwegian public during early and late stages of the pandemic, as well as characteristics that might be associated with these changes. METHODS In a longitudinal online survey, 12 580 participants completed self-report questionnaires in April 2020, including a retrospective assessment of contamination-related OCS severity (DOCS-SF) prior to COVID-19. In December 2020, 3405 (27.1%) of the participants completed the survey again. RESULTS In April, participants retrospectively recalled that their contamination-related OCS were lower prior to COVID-19 (d = 1.09). From April to December, symptoms slightly decreased (d = -0.16). The proportion of participants scoring above the clinical cut-off on DOCS-SF (≥16) changed accordingly from 2.4% pre-COVID to 27.8% in April and 24.0% in December. Previous severity of contamination-related OCS and symptoms of distress related to COVID-19 were the most powerful predictors of contamination-related OCS severity during the pandemic. CONCLUSIONS Elevated levels of contamination-related OCS were detected at both early and late stages of the pandemic, but the long-term symptom trend seems to be slightly declining.
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Affiliation(s)
- Torun Grøtte
- Department of Psychology, Norwegian University of Science and Technology, Norway
| | - Kristen Hagen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
- Molde Hospital, Møre og Romsdal Hospital Trust, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Norway
| | - Jarle Eid
- Department of Psychology, Norwegian University of Science and Technology, Norway
- Center for Crisis Psychology, University of Bergen, Norway
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
- Department of Clinical Psychology, University of Bergen, Norway
| | - Stephanie le Hellard
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
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Pacitti F, Socci V, D'Aurizio G, Jannini TB, Rossi A, Siracusano A, Rossi R, Di Lorenzo G. Obsessive-compulsive symptoms among the general population during the first COVID-19 epidemic wave in Italy. J Psychiatr Res 2022; 153:18-24. [PMID: 35792342 PMCID: PMC9239523 DOI: 10.1016/j.jpsychires.2022.06.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023]
Abstract
This study investigated obsessive-compulsive symptoms (OCS) in the Italian general population during the initial stage of the pandemic and the impact of COVID-19 related potential risk factors. A web-based survey was spread throughout the internet between March 27th and April 9th, 2020. Twenty thousand two hundred forty-one individuals completed the questionnaire, 80.6% women. The Dimensional Obsessive-Compulsive Scale (DOCS) was included to assess the severity of the obsessive-compulsive symptom domains. Further, selected outcomes were depression, anxiety, insomnia, perceived stress, and COVID-19 related stressful life events. A panel of logistic or linear regression analyses was conducted to explore the impact of COVID-19 related risk factors, socio-demographic variables, and mental health outcomes on OCS. A total of 7879 subjects (38,9%) reported clinically relevant OCS. Specifically, more than half of the sample (52%) reported clinically relevant symptoms in the Contamination domain, 32.5% in the Responsibility domain, 29.9% in the Unacceptable thoughts domain, and 28.6 in the Symmetry/Ordering domain. Being a woman was associated with OCS, except for Symmetry/Ordering symptoms. A lower education level and younger age were associated with OCS. Moreover, depression, anxiety, perceived stress symptoms, insomnia, and different COVID-19 related stressful events were associated with OCS. We found high rates of OCS, particularly in the contamination domain, in the Italian general population exposed to the first COVID-19 epidemic wave and COVID-19 related risk factors. These findings suggest the need to investigate further the trajectories of OCS in the general population along with the long-term socio-economic impact of the pandemic.
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Affiliation(s)
- Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | | | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | | | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Italy.
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Silverman ME, Nag S, Kalishman A, Cox PH, Mitroff SR. Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-7. [PMID: 35658099 DOI: 10.1080/07448481.2022.2080507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The long-term consequences of the COVID-19 pandemic on college students' mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points. PARTICIPANTS Undergraduate college students (N = 524) who volunteered for course credit. METHODS Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts. RESULTS Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility. CONCLUSIONS Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.
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Affiliation(s)
| | - Samoni Nag
- The George Washington University, Washington, DC, USA
| | | | - Patrick H Cox
- The George Washington University, Washington, DC, USA
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Demaria F, Pontillo M, Di Vincenzo C, Di Luzio M, Vicari S. Hand Washing: When Ritual Behavior Protects! Obsessive-Compulsive Symptoms in Young People during the COVID-19 Pandemic: A Narrative Review. J Clin Med 2022; 11:jcm11113191. [PMID: 35683574 PMCID: PMC9181440 DOI: 10.3390/jcm11113191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Francesco Demaria
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
- Correspondence: ; Tel.: +39-06-6859-2735; Fax: +39-06-6859-2450
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
| | - Cristina Di Vincenzo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
| | - Michelangelo Di Luzio
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Ong T, Wilczewski H, Soni H, Nisbet Q, Paige SR, Barrera JF, Welch BM, Bunnell BE. The Symbiosis of Virtual Reality Exposure Therapy and Telemental Health: A Review. FRONTIERS IN VIRTUAL REALITY 2022; 3:848066. [PMID: 37483657 PMCID: PMC10361704 DOI: 10.3389/frvir.2022.848066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Phobias and related anxiety are common and costly mental health disorders. Experts anticipate the prevalence of phobias will increase due to the COVID-19 pandemic. Exposure therapies have been established as effective and reliable treatments for anxiety, including recent innovations in virtual reality-based exposure therapy (VRET). With the recent advent of telemental health (TMH), VRET is poised to become mainstream. The combination of VRET and TMH has the potential to extend provider treatment options and improve patient care experiences. In this narrative review, we describe how recent events have accelerated VRET + TMH, identify barriers to VRET + TMH implementation, and discuss strategies to navigate those barriers.
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Affiliation(s)
- Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Hiral Soni
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | - Quinn Nisbet
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Janelle F. Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
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Kim HS, Ahn J, Lee J, Hong Y, Kim C, Park J, Chung S. The Mediating Effect of Reassurance-Seeking Behavior on the Influence of Viral Anxiety and Depression on COVID-19 Obsession Among Medical Students. Front Psychiatry 2022; 13:899266. [PMID: 35770057 PMCID: PMC9234214 DOI: 10.3389/fpsyt.2022.899266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Healthcare workers experienced great psychological burden due to the continuation of the COVID-19 pandemic. During the pandemic, medical healthcare workers experienced greater instances of insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms than the general population. This study aimed to explore the association between viral anxiety and obsession with COVID-19 among medical students with reassurance-seeking behavior as a mediator. METHODS In October 2021, an online survey was conducted among medical students at the University of Ulsan College of Medicine. The clinical characteristics of 162 participants and their responses to rating scales, including stress and anxiety to viral Epidemics-6 items (SAVE-6), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Patient Health Questionnaire-9 items (PHQ-9), and Obsession with COVID-19 scale were collected. RESULTS Medical students' obsession with COVID-19 was based on the PHQ-9 (β = 0.15, p = 0.01), SAVE-6 (β = 0.43, p < 0.001), and CRBS (β = 0.38, p < 0.001) scores (adjusted R2 = 0.49, F = 39.9, p < 0.001). Mediation analysis showed that medical students' viral anxiety and depression directly influenced their obsession with COVID-19, and their reassurance-seeking behavior partially mediated the effects of depression or viral anxiety on obsession with COVID-19. CONCLUSIONS Medical students' viral anxiety and depression may affect their obsession with COVID-19, and reassurance-seeking behaviors may mediate this. Therefore, medical students should adopt adaptive coping strategies to prevent high levels of viral anxiety and recurrent reassurance-seeking behavior.
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Affiliation(s)
- Hyun Sub Kim
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Junseok Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jukab Lee
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Youjin Hong
- Department of Psychiatry, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Changnam Kim
- Department of Psychiatry, Samsung Changwon Hospital, Sungkyunkwan University of Medicine, Changwon, South Korea
| | - Jangho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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12
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Grant JE, Drummond L, Nicholson TR, Fagan H, Baldwin DS, Fineberg NA, Chamberlain SR. Obsessive-compulsive symptoms and the Covid-19 pandemic: A rapid scoping review. Neurosci Biobehav Rev 2022; 132:1086-1098. [PMID: 34740755 PMCID: PMC8570941 DOI: 10.1016/j.neubiorev.2021.10.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been much speculation about untoward effects of the Covid-19 pandemic on psychological symptoms. OCD may be expected to be especially impacted. Our aim was to distil the current evidence base on relationships between the pandemic and obsessive-compulsive symptoms, in patients, and general population samples. METHODS We conducted a rapid scoping review, in the form of a systematic literature search, coupled with narrative review. 32 relevant papers were identified. RESULTS AND INTERPRETATION (1) A sizable proportion of people with OCD (but not all) experienced/reported symptom worsening during the pandemic, especially during initial restrictions (approximately 20-65 % of cases in longitudinal studies); (2) contamination/washing symptoms appeared particularly susceptible; and (3) OCD symptoms in general population samples were associated with trait compulsivity and pandemic-related-stress. The literature was heterogeneous with various methodological issues being commonplace. FUTURE DIRECTIONS The review identified important unaddressed issues: how should exposure based therapy be adapted during pandemics? How can we minimise harm from exacerbation of OCD in vulnerable individuals arising from public health messaging? Why do some but not all OCD patients experience worsening? And does Covid-19 infection affect (or lead to) OCD symptoms?
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Affiliation(s)
- Jon E. Grant
- Department of Psychiatry, University of Chicago, Chicago, USA
| | - Lynne Drummond
- South West London and St George’s NHS Trust and University of Hertfordshire, UK
| | - Timothy R. Nicholson
- Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Harry Fagan
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK
| | - David S. Baldwin
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK
| | - Naomi A. Fineberg
- National Treatment Service for OCD (England and Wales), Hertfordshire, UK
| | - Samuel R. Chamberlain
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK,Corresponding author at: Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK
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13
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Linde ES, Varga TV, Clotworthy A. Obsessive-Compulsive Disorder During the COVID-19 Pandemic-A Systematic Review. Front Psychiatry 2022; 13:806872. [PMID: 35401266 PMCID: PMC8989845 DOI: 10.3389/fpsyt.2022.806872] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/04/2022] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Elisabeth S Linde
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amy Clotworthy
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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14
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Mahaffey BL, Levinson A, Preis H, Lobel M. Elevated risk for obsessive-compulsive symptoms in women pregnant during the COVID-19 pandemic. Arch Womens Ment Health 2022; 25:367-376. [PMID: 34269873 PMCID: PMC8282770 DOI: 10.1007/s00737-021-01157-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/14/2021] [Indexed: 12/17/2022]
Abstract
The COVID-19 pandemic has led to a public mental health crisis with many people experiencing new or worsening anxiety. Fear of contagion and the lack of predictability/control in daily life increased the risk for problems such as obsessive-compulsive disorder (OCD) in the general population. Pregnant women may be particularly vulnerable to such pandemic-related stressors yet the prevalence of OC symptoms in this population during the pandemic remains unknown. We examined the prevalence of OC symptoms in a sample of 4451 pregnant women in the USA, recruited via targeted online methods at the start of the pandemic. Participants completed self-report measures including the Obsessive-Compulsive Inventory-Revised and the Pandemic-Related Pregnancy Stress Scale. Clinically significant OC symptoms were present in 7.12% of participants, more than twice as high as rates of peripartum OCD reported prior to the pandemic. Younger maternal age, income loss, and suspected SARS-CoV-2 infection were all associated with higher OC symptoms. Two types of pregnancy-specific stress, pandemic-related and pandemic-unrelated, were both associated with higher levels of OC symptoms. Pandemic-related pregnancy stress predicted OC symptoms even after controlling for non-pandemic-related, pregnancy-specific stress. Elevated rates of OC symptoms were observed in women pregnant during the pandemic, particularly those experiencing elevated pandemic-related pregnancy stress. This type of stress confers a distinct risk for OC symptoms above and beyond pregnancy-specific stress and demographic factors. Healthcare providers should be prepared to see and treat more peripartum women with OC symptoms during this and future public health crises.
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Affiliation(s)
- Brittain L. Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Putnam Hall, New York, NY 11794 USA
| | - Amanda Levinson
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Putnam Hall, New York, NY 11794 USA ,Department of Psychology, Stony Brook University, New York, NY 11794 USA
| | - Heidi Preis
- Department of Psychology, Stony Brook University, New York, NY 11794 USA ,Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, New York, NY 11794 USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, New York, NY 11794 USA
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15
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TÜRKÇAPAR MH, KAHYA Y, ÇAPAR-TAŞKESEN T, IŞIK H. Managing life during the pandemic: communication strategies, mental health, and the ultimate toll of the COVID-19. Turk J Med Sci 2021; 51:3168-3181. [PMID: 34284533 PMCID: PMC8771019 DOI: 10.3906/sag-2106-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/20/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim The purpose of this review was to present the ultimate toll of the COVID-19 pandemic by focusing on the communication strategies and mental health. Materials and methods We unsystematically reviewed the studies published between 2020 and 2021 from databases such as Google Scholar, Web of Science and ScienceDirect. Firstly, “new-normal” life challenges during the pandemic were discussed along with the public risk communication strategies. Later, mental health problems, posttraumatic growth, and protective factors were reviewed. Results Literature highlighted that individuals mainly experience COVID-19 related fear, anxiety, stress, negative emotions and sleep problems. Furthermore, the rates of clinically significant depression, anxiety, obsessive compulsive disorder, and posttraumatic stress disorder suggest an increase. Specifically, COVID-19 stress syndrome, loneliness, and sleep problems were associated with mental health problems in the pandemic. However, some individuals seem to be resilient to the COVID-19 trauma and experience posttraumatic growth. Brief online intervention studies are promising for reducing the emotional toll of the COVID-19 as well as for making individuals more resilient. Conclusion To conclude, the negative conditions of the pandemic seem to make some people, but not all, vulnerable to mental illness. In addition, framing the public warnings in an optimal emotional tone seems to be more effective to comply with the precautions.
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Affiliation(s)
- Mehmet Hakan TÜRKÇAPAR
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
| | - Yasemin KAHYA
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
| | - Tuğba ÇAPAR-TAŞKESEN
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
| | - Hatice IŞIK
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
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16
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Samuels J, Holingue C, Nestadt PS, Bienvenu OJ, Phan P, Nestadt G. An investigation of COVID-19 related worry in a United States population sample. J Psychiatr Res 2021; 144:360-368. [PMID: 34735840 PMCID: PMC8531673 DOI: 10.1016/j.jpsychires.2021.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although general anxiety has increased markedly since the onset of the COVID-19 pandemic, little has been reported about the demographic distribution of COVID-19 related worry, its relationship with psychological features, and its association with depression symptoms in the United States (US). METHODS 2117 participants, selected to represent the age, gender, and race/ethnic distributions of the US population, completed an online survey. Analysis of variance and correlation analyses were used to assess relationships between the COVID-19 related worry score and demographic characteristics, past psychiatric diagnoses, personality dimensions, and current psychological symptoms. Logistic regression was used to evaluate the association between the COVID-19 worry score and depression symptoms. RESULTS The COVID-19 worry score was markedly higher in younger (18-49 year-olds) than older participants, and moderately higher in men, those who were married or cohabiting, with post-college education, and/or living in large urban areas. The COVID-19 worry score also was markedly higher in those who reported having been diagnosed with a psychiatric disorder. The COVID-19 worry score correlated with neuroticism, current psychological symptoms, and COVID-19 risk and COVID-19 behavior scores. The COVID-19 worry score was associated with current depression symptoms (OR = 1.10, 95% CI = 1.09-1.11; p < 0.001) in univariable models and remained significant after adjustment for other correlates of depression, including COVID-19 risk. CONCLUSIONS In this US sample, the COVID-19 worry score was inversely related to age, strongly related to psychological symptoms, and independently associated with depression symptoms. These findings have implications for the community mental health response to the COVID-19 pandemic in the US.
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Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Calliope Holingue
- Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21201, USA
| | - Paul S. Nestadt
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Phillip Phan
- The Johns Hopkins University Carey Business School, Baltimore, MD, 21202, USA,Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
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17
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The immediate and long-term impacts of the COVID-19 pandemic on patients with obsessive-compulsive disorder: A one-year follow-up study. Psychiatry Res 2021; 306:114268. [PMID: 34837883 PMCID: PMC8562016 DOI: 10.1016/j.psychres.2021.114268] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/25/2021] [Accepted: 10/31/2021] [Indexed: 12/13/2022]
Abstract
Several recent publications have revealed that obsessive-compulsive disorder (OCD) patients were adversely affected during coronavirus disease 2019 (COVID-19); however, how long this negative impact will last is unclear. Our study aimed to investigate the impact of the COVID-19 pandemic on OCD patients after one year. Online questionnaires were administered, and clinical interviews were conducted to assess OCD symptoms, depression, anxiety, information about COVID-19 and mental resilience at baseline (1 December 2019-1 January 2020), during early COVID-19 (26 February-25 March 2020) and at the one-year follow-up (26 February-25 March 2021). A total of 110 OCD patients were enrolled. Our findings showed that OCD, depressive and anxiety symptoms worsened during early COVID-19, and the negative impact persisted at the one-year follow-up. Multivariate analysis showed that female gender, concern about COVID-19 and OCD symptom severity at baseline were risk factors for exacerbation of OCD symptoms during early COVID-19, while optimism, as one composite factor of resilience, was a protective factor against exacerbation of OCD symptoms both during early COVID-19 and at follow-up. Our study showed that COVID-19 had immediate and long-term impacts on the exacerbation of OCD symptoms, and interventions targeted at improving resilience are recommended.
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18
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Guzick AG, Candelari A, Wiese AD, Schneider SC, Goodman WK, Storch EA. Obsessive-Compulsive Disorder During the COVID-19 Pandemic: a Systematic Review. Curr Psychiatry Rep 2021; 23:71. [PMID: 34613498 PMCID: PMC8493778 DOI: 10.1007/s11920-021-01284-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 12/23/2022]
Abstract
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.
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Affiliation(s)
- Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100 Houston, TX, 77030, USA.
| | - Abigail Candelari
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100 Houston, TX, 77030, USA
| | - Andrew D Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100 Houston, TX, 77030, USA
| | - Sophie C Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100 Houston, TX, 77030, USA
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100 Houston, TX, 77030, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100 Houston, TX, 77030, USA
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19
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Fineberg NA, Pellegrini L, Wellsted D, Hall N, Corazza O, Giorgetti V, Cicconcelli D, Theofanous E, Sireau N, Adam D, Chamberlain SR, Laws KR. Facing the "new normal": How adjusting to the easing of COVID-19 lockdown restrictions exposes mental health inequalities. J Psychiatr Res 2021; 141:276-286. [PMID: 34271458 PMCID: PMC7611491 DOI: 10.1016/j.jpsychires.2021.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/24/2021] [Accepted: 07/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Re-establishing societal norms in the wake of the COVID-19 pandemic will be important for restoring public mental health and psychosocial wellbeing as well as economic recovery. We investigated the impact on post-pandemic adjustment of a history of mental disorder, with particular reference to obsessive-compulsive (OC) symptoms or traits. METHODS The study was pre-registered (Open Science Framework; https://osf.io/gs8j2/). Adult members of the public (n = 514) were surveyed between July and November 2020, to identify the extent to which they reported difficulties re-adjusting as lockdown conditions eased. All were assessed using validated scales to determine which demographic and mental health-related factors impacted adjustment. An exploratory analysis of a subgroup on an objective online test of cognitive inflexibility was also performed. RESULTS Adjustment was related to a history of mental disorder and the presence of OC symptoms and traits, all acting indirectly and statistically-mediated via depression, anxiety and stress; and in the case of OC symptoms, also via COVID-related anxiety (all p < 0.001). One hundred and twenty-eight (25%) participants reported significant adjustment difficulties and were compared with those self-identifying as "good adjusters" (n = 231). This comparison revealed over-representation of those with a history or family history of mental disorder in the poor adjustment category (all p < 0.05). 'Poor-adjusters' additionally reported higher COVID-related anxiety, depression, anxiety and stress and OC symptoms and traits (all p < 0.05). Furthermore, history of mental disorder directly statistically mediated adjustment status (p < 0.01), whereas OC symptoms (not OC traits) acted indirectly via COVID-related anxiety (p < 0.001). Poor-adjusters also showed evidence of greater cognitive inflexibility on the intra-extra-dimensional set-shift task. CONCLUSION Individuals with a history of mental disorder, OC symptoms and OC traits experienced greater difficulties adjusting after lockdown-release, largely statistically mediated by increased depression, anxiety, including COVID-related anxiety, and stress. The implications for clinical and public health policies and interventions are discussed.
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Affiliation(s)
- Naomi A. Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom,Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, United Kingdom,University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, United Kingdom; Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - David Wellsted
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Natalie Hall
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Valentina Giorgetti
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Dorotea Cicconcelli
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Elena Theofanous
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Nick Sireau
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - David Adam
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Samuel R. Chamberlain
- University of Southampton, Department of Psychiatry, Faculty of Medicine, Southampton, United Kingdom,Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Keith R. Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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