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.

The Persian Version of the COVID-19 Phobia Scale (Persian-C19P-S) and the Differences in COVID-19-Related Phobic Reactions in Patients with Anxiety Disorders.

Coronavirus disease 2019 (COVID-19) is a pandemic outbreak increasing several psychological distress, such as anxiety and phobia, and may affect patients with anxiety disorders. A scale has been recently designed to assess COVID-19-related phobic reactions named the COVID-19 Phobia Scale (C19P-S). The present study aimed to evaluate factor structure, reliability, and validity of the Persian version of the C19P-S (Persian-C19P-S) in patients with anxiety disorders and to compare COVID-19-related phobia among these patients. Three hundred patients with anxiety disorders completed the Persian-C19P-S and other scales assessing anxiety traits (e.g., the Short Health Anxiety Inventory (SHAI), the Health Concerns Questionnaire-54 (HCQ-54), and the Patient Health Questionnaire-4 (PHQ-4)) and COVID-19-related distress (e.g., the COVID Stress Scales (CSS) and the Fear of COVID-19 Scale (FCV-19)). The results showed that the Persian-C19P-S replicated the four-factor structure of the original C19P-S. Internal consistency and test-retest reliability coefficients evidenced the reliability of the scale. The validity of the scale (convergent and discriminant validity) was confirmed. Patients who had generalized anxiety and panic disorders showed higher phobic reactions related to COVID-19 than those with social anxiety disorder and specific phobia. This study indicates that the Persian version of the C19P-S is a valid scale to be used in Iranian patients with anxiety disorders to evaluate COVID-19-related phobia. Moreover, COVID-19-related phobic reactions are higher in some specific types of anxiety disorders.

The impact of the coronavirus pandemic on specific symptom dimensions and severity in OCD: A comparison before and during COVID-19 in the context of stress responses.

The present study aimed to compare a group of patients with obsessive-compulsive disorder (OCD; N = 270) before and during COVID-19 on specific obsessive-compulsive (OC) symptom dimensions and symptom severity. In addition, the study aimed to evaluate the associations of COVID-19-related stress responses with change in OC symptom dimensions and severity of symptoms as the result of the pandemic. Results showed that patients with OCD had higher scores on all OC symptom dimensions and symptom severity during the pandemic as compared to their scores from before the pandemic. Thus, the effect of COVID-19 is not limited to an increase in fears of contamination alone, but occurs across other symptom dimensions, including responsibility for harm, unacceptable thoughts, and symmetry. In addition, regression analyses indicated that COVID-19-related stress responses significantly predicted the observed increase in specific OC symptom dimensions and general severity, after controlling for pre-COVID-19 scores of symptoms and severity. The increase of symptoms as the result of COVID-19 might be best understood in the context of a non-specific stress-related response similar to the effects observed in non-clinical and other clinical populations.

The Persian COVID stress scales (Persian-CSS) and COVID-19-related stress reactions in patients with obsessive-compulsive and anxiety disorders.

The COVID Stress Scales (CSS) were designed to assess stress related to the COVID-19 pandemic. Emerging evidence indicates that people with anxiety disorders (ADs) and obsessive-compulsive disorder (OCD) may be more negatively impacted by COVID-19 than those with mood disorders or healthy individuals. Accordingly, this study sought to validate the Persian CSS (Persian-CSS) and to compare COVID-19-related stress reactions among patients with specific ADs and OCD. Patients with OCD (n = 300) and ADs (n = 310) completed the Persian-CSS and other scales developed to assess anxiety-related traits and COVID-19-related distress. The Persian-CSS replicated a five-factor structure similar to the original CSS in OCD and ADs. The total CSS and its scales had good reliability and validity. Patients with generalized anxiety disorder, panic disorder, and OCD had higher COVID-19 stress reactions than patients with social anxiety disorder and specific phobia. Patients with panic disorder had higher danger and contamination fears and xenophobia than patients with OCD. The study suggests that the Persian-CSS is a valid scale to be used in patients with OCD and ADs, each of whom differs in their specific patterns of COVID-19-related stress reactions.