Covid19 06 Dec, 2022 Read Time: 4 mins

New Canadian insight on obsessive-compulsive disorder (OCD) during the COVID-19 pandemic

The prevalence of OCD symptoms in the general population increased during the early stage of the COVID-19 pandemic, with a rate significantly higher than pre-pandemic, according to a provincial study from the University of Alberta.

The study, presented by Dr. Adam Abba-Aji at the 2022 CPA conference, found that individuals who experienced OCD symptoms since the start of the pandemic were more likely to also have high levels of stress, anxiety, and depressive symptoms.1

Obsessive-compulsive disorder (OCD) and the COVID-19 pandemic

OCD is defined by intrusive obsessions and repetitive compulsions, often centered around potential harm to oneself and others.2 

OCD can become chronic when left untreated, leading to poor quality of life and significant suffering for the individual and their families.3 Also, OCD is highly comorbid with other mental health conditions, including other anxiety disorders and depression.4

The lifetime prevalence of OCD is 2-3%;5 however the lifetime prevalence of one or more OCD symptoms is over 25% in the general population.6

The interplay between genes, environment, life stressors, and excessive worry contribute to the development of OCD.7,8

The COVID-19 pandemic caused significant stress, uncertainty, and worry, especially in the early stages. “During the initial part of COVID, people were really stressed by seeing COVID on the screen all the time and information overload,” Dr. Abba-Aji said. “Around the period of the COVID, there were [also] lots of uncertainty about the [COVID] disease itself.”

“Symptoms of OCD are linked to cognitive biases and intolerance to uncertainty.”

Restrictive measures and limitations were enforced to control the spread of COVID-19 infection. For example, people were asked to distance physically, stay home, and avoid social gatherings. Also, public health authorities extensively recommended regular handwashing and good hygiene to reduce the chance of getting and spreading COVID-19 infection.

While these measures were crucial in fighting against COVID-19, “public health restrictions for protection against communicable diseases have been proven to cause mental health issues,” Dr. Abba-Aji pointed out. Additionally, constant worry for self and family members is another risk factor for mental health during a pandemic.8

So, would COVID-19 pandemic-induced worry, limitations, and obsession with handwashing lead to more people experiencing OCD symptoms?

Dr. Abba-Aji and his research team tried to answer this question.

Details of the study

This was an online survey-based population study conducted in partnership with Alberta Health Services across the province of Alberta. The research team reached out to 32,805 individuals in the last week of March 2020 using a text message service. Of these, 6041 (18.4%) completed the online survey.

The survey included questionnaires to assess the following:

  • OCD symptoms, using the Brief Obsessive-Compulsive Scale (BOCS)
  • Level of stress, using the Perceived Stress Scale (PSS)
  • Likely generalized anxiety disorder (GAD), using the Generalized Anxiety Disorder 7-item (GAD-7) scale
  • Likely major depressive disorder (MDD), using the Patient Health Questionnaire-9 (PHQ-9) scale

 

“The results of the study were alarming,” Dr. Abba-Aji explained:

  • More than half of the respondents (60.3%) reported OCD symptoms during the COVID-19 pandemic. These individuals were also more likely to have a high level of stress, anxiety, and depressive symptoms during the pandemic compared to those who did not experience OCD symptoms.

 

  • Half of the respondents (53.8%) had compulsion specifically to wash their hands repeatedly or in a special way during the COVID-19 pandemic.  The act of repeated handwashing or washing in a special way was deemed an OCD symptom, according to the study. These individuals were also more likely to have high levels of stress and anxiety symptoms compared to those who did not have handwashing compulsion.

More people experienced OCD symptoms and compulsive handwashing during the early stage of the COVID-19 pandemic, according to a Canadian study of six thousand Albertans.

Key takeaway

This study adds to the evidence about the negative effect of the COVID-19 pandemic on individuals’ psychological well-being, showing a surge in OCD symptoms in the general population during the early stage of the pandemic.

While the results are interesting, “[The increased] OCD symptoms may be a reflection of the real threat posed by COVID-19.” Dr. Abba-Aji acknowledged. “It is possible that once the pandemic is over, these [OCD] symptoms decimate.”

So, “future studies are needed to determine the temporality between OCD symptoms and the COVID-19 pandemic when the pandemic is over,” Dr. Abba-Aji concluded.

Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

References

1.  Abba-Aji A, et al. International Journal of Environmental Research and Public Health. 2020;17(19):E6986.

2.  Drubach DA. Continuum. 2015 Jun;21(3 Behavioral Neurology and Neuropsychiatry):783-8.

3.  Fineberg NA, et al. European Neuropsychopharmacology. 2019;29(4):549-565.

4.  Lochner C, et al. Comprehensive Psychiatry. 2014;55(7):1513-1519.

5.  Karno M, et al. Archive of General Psychiatry. 1988;45(12):1094-1099.

6.  Ruscio AM, et a. Molecular Psychiatry. 2010;15(1):53-63.

7.  Cromer KR, et al. Behaviour Research and Therapy.  2007;45(7):1683-1691.

8.  López-Solà C, et al. British Journal of Psychiatry. 2016;208(1):26-33.

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