How is COVID-19 affecting patients with obsessive–compulsive disorder?

P. Alonso1,2,3,4 * , S. Bertolín1,2,4 , J. Segalàs1,2,3,4 , M. Tubío-Fungueiriño 5,6,7 , E. Real1,2,4 , L. Mar-Barrutia1 , M. Fernández-Prieto5,6,8 , S. Carvalho10,9 , A. Carracedo5,6,7,8 and JM. Menchón1,2,3,4
1OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; 2Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain; 3Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; 4CIBERSAM (Centro de Investigación en Red
de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; 5Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; 6Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras
(CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; 7Fundación Pública Galega deMedicinaXenómica,ServicioGalegodeSaúde(SERGAS),SantiagodeCompostela,Spain;8GrupodeGenética,Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; 9Psychological Neuroscience
Laboratory, CIPsi, SchoolofPsychology,UniversityofMinho,CampusdeGualtar,Braga,Portugaland10DepartmentofEducationand Psychology, University of Aveiro, Portugal; Department of Biology and William James Center for Research, University of Aveiro, Portugal

Presented By: Group 13 (Roll no: 103, 104, 105, 106, 107, 109)

Introduction Method Result Discussion

On January 30, 2020, the World Health Participants While the initial months of the pandemic brought
Organization declared the global COVID-19 One hundred twenty seven patients with OCD who attended a moderate symptom worsening for many OCD
outbreak to be an international public health specialist OCD Clinic in Barcelona , Spain were assessed by phone patients, especially those with pre-existing
emergency, and on March 11, declared that it had from April 27 to may 25 , 2020, during the early phase of the vulnerabilities, a significant portion showed
become a pandemic. This led to widespread pandemic and a structured interview that collected clinical and resilience. This study in Spain aligns with others,
adoption of hygiene practices and social socio-demographic information and for the control group, 237 highlighting increased anxiety, depression, and
distancing, resembling behaviors seen in participants above 18 years old were recruited from the same suicidal risk among OCD patients compared to
Obsessive-Compulsive Disorder (OCD) patients. geographic area. healthy controls. Interestingly, while some studies
The pandemic has caused significant reported higher worsening rates, ours captured a
psychological distress in the general population 65.3% increase, similar to other findings. Notably,
and health workers. Almost 40% of the general Procedure 15% of patients even saw improvement, suggesting
population and more than 70% of health workers At an initial treatment two independent psychiatrists fulfilled the potential adaptation.
refer to psychological distress, insomnia, anxiety, diagnostic criteria for OCD of the OCD patients .After 1st Perceived social support played a crucial role, with
and depressive symptoms. However, data on assessment patients received pharmacological treatment or CBT lower support predicting symptom deterioration,
COVID-19 impact on OCD patients, who are .WE contacted those patients who have completed at least one year emphasizing the importance of fostering social
more likely to worry about contracting diseases, is treatment in our center and had been on stable doses of medication connections even during lockdowns. These findings
limited. Two recent reports of patients with OCD for at least 3 months. Patients received outpatient follow up by echo concerns about the potential for increased
from northern Italy suggest worsening symptoms telephone and informing the patients about our study and purposes addictive behaviors as coping mechanisms,
in a third of OCD patients, particularly those with .Those who agreed to participate underwent a structured interview underlining the need for accessible support systems
contamination fears. The pandemic has introduced that lasts for 20-25 minutes. Participants of the control group were for vulnerable populations like OCD patients.
stressors like home confinement, limited freedom, recruited through social network or snowball method. Adapted During the pandemic, 60% of OCD patients,
economic uncertainty, and limited access to version of structured interview that was delivered to the OCD group especially those afraid of contamination, have
mental health services. These could trigger OCD was sent as an online survey to the participants who provided struggled with new fears of getting COVID-19.
symptoms, but some patients may find relief in the written consent of the participation. Descriptive statistics were Treating them is tricky because exposure therapy can
social acceptance of behaviors like frequent hand calculated and are reported. Independent sample Student t-test and raise infection risks. Adjusting therapy and using
washing. We hypothesize that factors like baseline Pearson Chi-squared were carried out to explore the differences in telemedicine are important for their care. Many
OCD severity, symptom profiles, comorbid sociodemographic and clinical variables between the OCD and the needed medication changes, with 25% requiring
conditions, social support, and exposure to control group paired sample Student t-test were also performed to adjustments. We must consider each patient's access
COVID-19 news could predict changes in OCD assess potential changes in OCD severity from before to after the to technology and age. The study has limitations, but
status, helping develop prevention strategies for COVID-19 outbreak. it's clear that OCD patients need ongoing support
vulnerable patients. during the pandemic to avoid worsening mental
Measures health, with one in three experiencing increased
Objectives of the study The structured interview that we designed specifically for this depressive and suicidal symptoms.
This study aims to evaluate the impact of the study assessed seven thematic blocks:
COVID-19 pandemic on OCD patients, Its 1. Sociodemographic data Conclusions
objectives are as following: 2. Social context
1. Assessing changes in OCD severity. 3. Contact with COVID-19 The COVID-19 pandemic has significantly impacted
4. Medical conditions the emotional health of patients with OC. A study of
2. Assessing changes in pre-existing conditions,
5. Emotional regulation and stress coping strategies 127 patients with OCD in Barcelona, Spain, found that
treatment, use of mental health resources, and 65.3% of OCD patients experienced a worsening of
coping strategies. 6. General psychiatric data
their symptoms, with only 31.4% experiencing a
3. Assessing changes in newly developed 7. OCD-related questions(OCD group only)
significant increase in Y-BOCS scores. The risk of
conditions. getting infected by SARS-CoV2 was reported as a new
Measuring Instrument obsession by 44.8%, but only became the main
Rationale of the Study 1. Visual analog scale (VAS; 0 = no anxiety/no depressive obsession concern in approximately 10% of patients.
The research addresses gaps in existing symptoms and 10 = severely anxious/depressed); suicidal ideation Suicide-related thoughts were more frequent among
literature by focusing on these crucial factors and according to the Hamilton Depression Rating Scale (HDRS; item on OCD patients than healthy controls. The presence of
aims to offer insights for policymakers to enhance suicide). Development of new psychiatric symptoms was assessed pandemic depression, higher Y-BOCS scores,
students' academic achievements and generic by a battery of questions adapted from the Structured Clinical contamination/washing symptoms, and lower perceived
Interview for DSM-5-Clinician version. social support predicted a significantly increased risk of
competences in higher education.
2. Yale–Brown Obsessive–Compulsive Scale (Y-BOCS). The Y- OCD worsening. Most patients with OCD seem to be
capable of coping with the emotional stress during the
BOCS rates obsessions and compulsions separately on five
initial phase of the pandemic, but the current crisis
dimensions: time spent, degree of interference, distress, resistance
poses a risk factor for a significant worsening of
and perceived control over symptoms. The 10 Y-BOCS items are symptoms and suicidal ideation. Action is needed to
each scored on a 4-point scale from 0 (none) to 4 (extreme). Total ensure effective and individualized follow-up care for
score ranges from 0 to 40 (0–7: subclinical; 8–15: mild; 16–23: OCD patients during the COVID-19 era.
moderate; 24–31: severe; and 33–40: extreme OCD).