When a nightmare comes true: Change in obsessive-compulsive disorder over the first months of the COVID-19 pandemic

TY - JOUR

T1 - When a nightmare comes true: Change in obsessive-compulsive disorder over the first months of the COVID-19 pandemic

AU - Jelinek, Lena

AU - Voderholzer, Ulrich

AU - Moritz, Steffen

AU - Carsten, Hannes Per

AU - Riesel, Anja

AU - Miegel, Franziska

N1 - Funding Information: We would like to thank Gloria R?hrig for her help with the data collection. The authors declare no conflict of interest. Publisher Copyright: © 2021 Elsevier Ltd

PY - 2021/12

Y1 - 2021/12

N2 - The outbreak of the COVID-19 pandemic has particularly affected people with obsessive-compulsive disorder (OCD). Exacerbation of obsessive-compulsive symptoms (OCS) has been suspected for those with contamination-related OCD (C-OCD). However, the course of OCS over the ongoing pandemic remains unclear. We assessed 268 participants with OCD (n = 184 with C-OCD) in an online survey at the beginning of the pandemic in Germany, reassessing 179 participants (66.8%, 104 C-OCD) three months later. We assessed severity of OCD (OCI-R), depression (PHQ-9), experiential avoidance, as well as functional and dysfunctional beliefs. Overall, OCS and depressive symptoms did not substantially change over time. However, when people with and without C-OCD were compared, symptoms improved in patients without C-OCD (nC-OCD) but remained stable in patients with C-OCD over time. Symptom improvement was associated with male gender, higher initial OCI-R, and nC-OCD. Experiential avoidance and beliefs at the beginning of the pandemic did not generally predict change in OCS. People with OCD, particularly those with nC-OCD, showed tentative signs for signs of adapting, whereas distress in those with C-OCD remained at a high level, underlining the burden for these patients. Clinicians should be informed about how to maintain effective treatment for C-OCD during a pandemic.

AB - The outbreak of the COVID-19 pandemic has particularly affected people with obsessive-compulsive disorder (OCD). Exacerbation of obsessive-compulsive symptoms (OCS) has been suspected for those with contamination-related OCD (C-OCD). However, the course of OCS over the ongoing pandemic remains unclear. We assessed 268 participants with OCD (n = 184 with C-OCD) in an online survey at the beginning of the pandemic in Germany, reassessing 179 participants (66.8%, 104 C-OCD) three months later. We assessed severity of OCD (OCI-R), depression (PHQ-9), experiential avoidance, as well as functional and dysfunctional beliefs. Overall, OCS and depressive symptoms did not substantially change over time. However, when people with and without C-OCD were compared, symptoms improved in patients without C-OCD (nC-OCD) but remained stable in patients with C-OCD over time. Symptom improvement was associated with male gender, higher initial OCI-R, and nC-OCD. Experiential avoidance and beliefs at the beginning of the pandemic did not generally predict change in OCS. People with OCD, particularly those with nC-OCD, showed tentative signs for signs of adapting, whereas distress in those with C-OCD remained at a high level, underlining the burden for these patients. Clinicians should be informed about how to maintain effective treatment for C-OCD during a pandemic.

KW - Contamination fear

KW - COVID-19

KW - Experiential avoidance

KW - Obsessive-compulsive disorder

KW - Pandemic

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85118794279&partnerID=8YFLogxK

U2 - 10.1016/j.janxdis.2021.102493

DO - 10.1016/j.janxdis.2021.102493

M3 - SCORING: Journal article

AN - SCOPUS:85118794279

VL - 84

SP - 102493

JO - J ANXIETY DISORD

JF - J ANXIETY DISORD

SN - 0887-6185

M1 - 102493

ER -