Effects of strict COVID-19 lockdown on patients with obsessive-compulsive disorder compared to a clinical and a nonclinical sample.

BACKGROUND: Symptoms of obsessive-compulsive disorder (OCD) have been reported to increase during the COVID-19 lockdowns because of the hygiene requirements related to the pandemic. Patients with adjustment disorder (AD) may, in turn, represent a vulnerable population for identifiable stressors. In this study, we aimed at assessing potential symptoms changes in OCD patients during the lockdown in comparison with AD patients as well as versus healthy controls (HC). METHODS: During the COVID-related lockdown, we enrolled 65 patients and 29 HC. Participants were tested with four clinical rating scales (Yale-Brown obsessive-compulsive scale and Brown Assessment of Beliefs Scale for OCD patients; Beck Depression Inventory-II and State-Trait Anxiety Inventory-Y for each group) that had been also administered just before the Italian lockdown. RESULTS: Our results showed that during the lockdown: (i) the symptoms of depression and anxiety increased in all groups, but this increase was most pronounced in HC (p < 0.001); (ii) OCD symptoms severity did not increase, but the insight worsened (p = 0.028); (iii) the proportion of OCD patients showing hygiene-related symptoms increased (p = 0.031 for obsessions of contamination), whereas that of patients with checking-related symptoms decreased. CONCLUSIONS: The lockdown-induced psychological distress apparently changed the characteristics and the pattern of OCD symptoms expression but not their overall severity. This evidence confirms the heterogeneity and changing nature of OCD symptoms, strongly depending on the environmental circumstances.

The Relationship Between Fear, Obsession and Quality of Life in Chronic Patients Due to Covid-19 Pandemic.

AIM: Excessive fear and repetitive negative thoughts about COVID-19 in individuals with chronic diseases, who are among high risk group in COVID-19 pandemic may cause psychological disorders such as obsession and affect the quality of life negatively. This study was conducted to examine the relationship between fear, obsessive behaviors and quality of life in chronic patients due to COVID-19 pandemic. SUBJECTS AND METHODS: This descriptive and cross-sectional study was carried out between October 5 and 31, 2020. The survey form was sent online to individuals with a chronic disease who were 18 and older. 255 individuals who responded to surveys were included in the study. The data were collected with Personal Information Form, Fear of COVID-19 Scale (FCV-19S), Obsession with COVID-19 Scale (OCS) and World Health Organization Quality of Life Brief Form (WHOQOL-BREF-TR). RESULTS: Fear of COVID-19 Scale mean score was found as 21.99±7.28, OCS mean score was found as 4.78±3.62, WHOQOL-BREF-TR physical subdomain mean score was found as 13.58±3.35, psychological subdomain mean score was found as 14.19±3.29, social subdomain mean score was found as 14.13±3.66, environmental subdomain mean score was found as 14.16±3.36, and national environmental subdomain mean score was found as 13.83±2.82. A positive and moderate significant correlation was found between FCV-19S and OCS (r=0.571, p=0.000). A positive and very weak significant correlation was found between OCS and WHOQOL-BREF-TR physical subdomain (r=0.166, p=0.00). CONCLUSION: The participants were found to have high levels of fear of COVID-19 and low levels of obsession with COVID-19. It was found that individuals' fears increased obsessive thoughts and obsessive thoughts positively affected quality of life.

Comparison of Death Anxiety, Death Obsession, and Humor in Nurses and Medical Emergency Personnel in COVID-19 Pandemic.

INTRODUCTION: COVID-19 has created numerous challenges for the health system. Nurses and medical emergency personnel are at the forefront of fighting COVID-19 and exposed to psychological disorders such as death anxiety and death obsession. Humor is a defense and coping mechanism against the anxiety and obsession associated with death. This study aimed to compare death anxiety, death obsession, and humor among nurses and medical emergency personnel during the COVID-19 pandemic. METHODS: This descriptive cross-sectional study was conducted with 230 nurses and medical emergency personnel. To collect data, the Templer death anxiety scale, death obsession scale, and humor styles questionnaire were used. SPSS 19 was used for data analysis. The significance level was considered at P < .05. RESULTS: Mean and standard deviation of death anxiety in the nurses and medical emergency personnel were 6.86 (4.04) and 5.68 (3.57), respectively; these values for death obsession were 29.82 (12.30) and 25.30 (12.66) and for humor 116.75 (30.87) and 118.48 (24.66), respectively. The nurses had significantly higher death anxiety (t = 2.33, P = .02) and death obsession (t = -2.68, P = .008) than the medical emergency personnel; moreover, there was no significant relationship among humor, death anxiety (r = .11, P = .10), and death obsession (r = .07, P = .31) in nurses and emergency personnel. DISCUSSION: The results of this study showed that the levels of death anxiety and death obsession were higher in the nurses than the medical emergency personnel. There was no significant difference between the hospital nurses and medical emergency personnel in terms of humor.

Mediating Effects of Reassurance-Seeking Behavior or Obsession With COVID-19 on the Association Between Intolerance of Uncertainty and Viral Anxiety Among Healthcare Workers in Korea.

BACKGROUND: This study explores whether the intolerance of uncertainty among healthcare workers prompts viral anxiety, and whether this association is mediated by their reassurance-seeking behavior and preoccupation with the coronavirus disease 2019 (COVID-19) in Korea. METHODS: An online survey was conducted among healthcare workers in Asan Medical Center, on November 29, 2021. Demographic characteristics and responses to items from rating scales were collected, including Stress and Anxiety to Viral Epidemics-9, Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Obsession with COVID-19 Scale (OCS), Patient Health Questionnaire-9, Insomnia Severity Scale, and Intolerance of Uncertainty-12 (IUS-12). RESULTS: Among the 329 participants, viral anxiety of healthcare workers was predicted by being female (ß = 0.14, P = 0.002), CRBS (ß = 0.30, P < 0.001), OCS (ß = 0.32, P < 0.001), and IUS-12 (ß = 0.15, P = 0.002) scores (adjusted R² = 0.43, F = 31.1, P < 0.001). Mediation analysis showed that the intolerance of uncertainty directly influenced viral anxiety, and reassurance-seeking behavior and obsession with COVID-19 partially mediated the association. CONCLUSION: The intolerance of uncertainty among healthcare workers directly influenced their viral anxiety, and reassurance-seeking behavior and obsession with COVID-19 mediated this association in this era of "living with coronavirus" in Korea.

Mental health of Brazilian university students during the Covid-19 / Saúde mental dos estudantes universitários brasileiros durante a pandemia de Covid-19 / Salud mental de estudiantes universitarios brasileños durante la pandemia Covid-19

This study aimed to investigate the effects of positive and negative affects, anxiety, and obsessive and compulsive thoughts and behaviors on Brazilian university students during the Covid-19 pandemic. Participated in this study 492 students, aged 18 years or over, from all regions of the country. The survey was conducted between April and May 2020, using self-report instruments applied in the online format. The results indicated that 37% (N=182) of the students had a high level of anxiety and 46.1% (N=227) moderate levels for obsessive and compulsive thoughts and behaviors. In addition, it was found that positive affects were negatively correlated with anxiety, as well as with obsessive and compulsive thoughts and behaviors, while negative affects were positively correlated with independent variables. It is concluded that the mental health of university students must be monitored during pandemics.

Este estudo teve como objetivo investigar os efeitos dos afetos positivos e negativos, da ansiedade e dos pensamentos e comportamentos obsessivos e compulsivos nos estudantes universitários brasileiros durante a pandemia da Covid-19. Participaram deste estudo 492 estudantes de todas as regiões do país e com idades a partir de 18 anos. A pesquisa foi realizada entre os meses de abril e maio de 2020, por meio de instrumentos de autorrelatos aplicados no formato on-line. Os resultados indicaram que 37% (N = 182) dos estudantes apresentaram alto nível de ansiedade e 46,1% (N = 227) níveis moderados para os pensamentos e comportamentos obsessivos e compulsivos. Além disso, verificou-se que os afetos positivos se relacionaram negativamente à ansiedade, assim como se relacionaram negativamente aos pensamentos e comportamentos obsessivos e compulsivos, enquanto os afetos negativos se relacionaram positivamente às variáveis independentes. Conclui-se que a saúde mental dos estudantes universitários deve ser monitorada durante pandemias.

Este estudio tuvo como objetivo investigar los efectos de los afectos positivos y negativos, la ansiedad y los pensamientos y comportamientos obsesivos y compulsivos en estudiantes universitarios brasileños durante la pandemia de Covid-19. En este estudio participaron 492 estudiantes de todas las regiones del país y mayores de 18 años. La encuesta se realizó entre los meses de abril y mayo de 2020, utilizando instrumentos se autoinforme aplicados en formato online. Los resultados indicaron que el 37% (N = 182) de los estudiantes tenían niveles altos de ansiedad y el 46,1% (N = 227) niveles moderados de pensamientos y comportamientos obsesivos y compulsivos. Además, se encontró que los afectos positivos se correlacionaron negativamente con la ansiedad, así como el pensamiento y el comportamiento obsesivo y compulsivo se correlacionaron negativamente, mientras que los afectos negativos se correlacionaron positivamente con variables independientes. Se concluye que la salud mental de los estudiantes universitarios debe ser monitoreada durante las pandemias.

COVID-19 and psychosis, depression, obsession and quality of life in Lebanese patients with schizophrenia: Any changes after 5 months of quarantine?

BACKGROUND: Previous research revealed an absence of any previous studies reporting the impact that pandemics may have on psychotic symptomology, nor on the physical health of people with psychosis in response to the epidemics of the COVID-19. The direction of the impact of the COVID-19 on schizophrenia is unknown, as the risk of infection could vary from patients to patients according to clinical comorbidities, cognitive impairment, acute symptoms, and family support. To the best of our knowledge, no study has provided details on the variation of symptoms in patients with schizophrenia during the quarantine of COVID-19 outbreak. Therefore, the primary objective of the study is to investigate the variation of psychotic symptoms, depression, obsession and quality of life in patients with schizophrenia before and after 5 months of quarantine and evaluate factors associated with these variations during the quarantine period. METHODS: A cross-sectional study was performed on a sample of 190 chronic patients institutionalized for schizophrenia for more than 1 year at the Psychiatric Hospital of the Cross. The baseline assessment was done in December 2019; the second assessment was done in August 2020 (5 months after the lockdown). RESULTS: Getting updates about the coronavirus minimally, some and most of the times were significantly associated with a decrease in positive psychotic and psychopathologic symptoms 5 months after quarantine compared to before it. Practicing religiosity some and all the time versus not was significantly associated with a decrease in negative, psychopathology symptoms and total PANSS score after 5 months of quarantine compared to before it. Finally, female gender (B = 1.77) was significantly associated with an increase in the WHO Domain 3 score (better social relations) after 5 months of quarantine compared to before it. CONCLUSION: Patients with schizophrenia fare better symptomatically after 5 months of quarantine if they receive constant updates about COVID-19 and if they tended to practice religiosity.

Self-Reported Obsession Toward COVID-19 Preventive Measures Among Undergraduate Medical Students During the Early Phase of Pandemic in Jordan.

Background: Coronavirus disease 2019 (COVID-19) pandemic and its associated precautionary measures have substantial impacts not only on the medical, economic, and social context but also on psychological health. This study aimed to assess the obsession toward COVID-19 preventive measures among undergraduate medical students during the early phase of the pandemic in Jordan. Methods: Online questionnaires were distributed between March 16, 2020 and March 19, 2020. Socio-demographic characteristics were collected, and self-reported obsession toward COVID-19 preventive measures was assessed using a single question.COVID-19 knowledge, risk perception, and precautionary measures were evaluated using scales. Using the chi-square test, Student t-test, and one-way ANOVA, we assessed the differences in the obsession of students with socio-demographic characteristics and scores of the scales. Results: A total of 1,404 participants (60% were female participants) completed the survey with a participation rate of 15.6%. Obsession with preventive measures was reported by 6.8%. Obsession was significantly more common among women (9.2%) than men (3.3%) and students who attended COVID-19 lectures (9.5%) than those who did not attend such lectures (5.8%) (p < 0.001 and p = 0.015, respectively). Obsessed participants reported significantly higher levels of COVID-19 knowledge (p = 0.012) and precautionary measures (p < 0.001). COVID-19 risk perception had a mild effect size difference but with no statistical significance (p = 0.075). There were no significant differences in the academic levels of participants (p = 0.791) and universities (p = 0.807) between students who were obsessed and those who were not. Conclusions: Obsession is one of the significant but unspoken psychological effects of COVID-19 precautionary measures among undergraduate medical students. Medical schools should be equipped with means to handle pandemic psychological effects.

Psychological impact of COVID-19 and contributing factors of students' preventive behavior based on HBM in Gondar, Ethiopia.

BACKGROUND: The Ethiopian Federal government has locked down schools as one measure to contain Covid-19 pandemic. Psychological effect of COVID-19 on students is increased due to the reopening of schools. The psychological effect of the pandemic is increasing along with physical aspect of health. Therefore, this study aimed to assess the psychological impact of Covid-19 and its contributing factors of students' behavior in Ethiopia. METHODS: A cross sectional design was conducted from November to December 2020. Data were collected using pre tested self- administered questionnaire from secondary school students in Gondar city North West Ethiopia. Stratified simple random sampling technique was used to select 403 secondary school students. Data were entered and cleaned with Epidata version 4.62 and exported for analysis STATA version 14. Multivariable logistic regression and multiple linear regression were used to show the association of dependent and independent variables. Independent variables in relation to dependent variable measured using odd ratios and B coefficient with 95% confidence interval for Covid-19 anxiety and preventive behavior of Covid-19 respectively were used. RESULTS: A total of 370 students were participated giving response rate of 92%. The prevalence of Covid-19 anxiety and obsession among secondary school students were 38.1% and 40.27% respectively. Being 11thgrade 54% (AOR = 0.46; 95%CI:0.22, 0.95) and increased knowledge16% (AOR = 0.84;95%CI: 0.77, 0.89) score associated with decreased COVID-19 anxiety while Covid-19 obsession, 14.51 times (AOR = 14.51;95%CI: 8.05, 26.17), and being female 1.6 times (AOR = 1.6; 95%CI: 1.01, 2.51) increased Covid-19 Anxiety. Furthermore, increased self-efficacy 0.5 times (B = 0.5; 95%CI: 0.28, 0.62), and increased cues to action 0.4 times (B = 0.4; 95% CI: 0.19, 0.69) increased preventive behavior of Covid-19 while perceived barrier 0.1 times (B = -0.1; 95%CI:-0.22, 0.01) decrease preventive behavior of Covid-19. CONCLUSION: Almost two individuals of five participants developed COVID-19 anxiety and COVID-19 obsession. Being grade 11th and knowledge were negatively associated with anxiety while being female and being obsessed with COVID-19 were positively associated with anxiety. No variable was associated with obsession of Covid-19. Intervention is needed to reduce anxiety among females. Furthermore, perceived barrier, self-efficacy and cues to action were significant factors of preventive behaviour of Covid-19. Therefore, to increase preventive behaviour of Covid-19, information, education and communication and behavioural change communication should be targeted on reducing barriers and increasing motivations and confidences.

Measuring COVID-19 related anxiety and obsession: Validation of the Coronavirus Anxiety Scale and the Obsession with COVID-19 Scale in a probability Chinese sample.

BACKGROUND: With concern over the rise in mental health symptoms associated with the COVID-19 pandemic, the present study set out to address the absence of pandemic-specific screening tools for detecting those in Chinese societies who are at-risk for experiencing mental distress due to the pandemic; thus, its aim was to validate the Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) in Chinese adults. METHODS: With a two-stage cluster random sampling method, we surveyed 1011 Chinese community-dwelling adults (38.8% men; 41.2 years old on average with an SD of 15.8) in June and July of 2020. RESULTS: Our psychometric evaluation results showed that the Chinese version of CAS and OCS retained their original one-dimensional structure and demonstrated measurement invariance across genders. In line with validation studies of the CAS and OCS in other languages, subsequent analyses also provided support to our Chinese version with respect to their satisfactory internal consistency (α = .87 and .73, respectively), and good concurrent validity (i.e., positive associations with negative feelings, excessive time-consumption, subjective distress, and functioning impairment). LIMITATIONS: Due to constraints of time and cross-sectional design, we only validated CAS and OCS among Chinese adults and did not evaluate their test-retest reliability nor predictive validity. CONCLUSIONS: Considering the practical benefits of understanding the source of mental symptoms during the pandemic, we recommend the use of CAS and OCS in Chinese communities to facilitate early identification and intervention for those who require clinical attention due to their COVID-19 related anxiety and obsessive thoughts.

Death anxiety and burnout in intensive care unit specialists facing the COVID-19 outbreak: The mediating role of obsession with COVID-19 and coronaphobia.

The aim of the study was to examine the role of the obsession with COVID-19 thoughts and coronaphobia in the relationship of death anxiety with burnout among staff working at infectious diseases hospitals in the front-line of the fight against COVID-19. A cross-sectional online survey (N = 110) was conducted during the second wave of the COVID-19 pandemic. Results showed that obsession with COVID-19 and coronaphobia mediated the relationship of death anxiety with burnout. Most of the participants reported higher levels of death anxiety compared with the general population and nurses reported higher levels of death anxiety than physicians.

Contamination-related behaviors, obsessions, and compulsions during the COVID-19 pandemic in a United States population sample.

BACKGROUND: Contamination-prevention behaviors such as mask wearing and physical distancing are crucial to reduce coronavirus transmission during the COVID-19 pandemic. We hypothesized that engagement in these behaviors could provoke obsessions and phobias in vulnerable individuals in the community. METHODS: A total of 2117 participants, systematically selected to represent the age, gender, and race distributions of the US population, completed an online survey that assessed demographic characteristics, clinical features, COVID-19 risks, and COVID-19 contamination-prevention behaviors. Logistic regression was used to estimate the magnitude of the relationships between the COVID-19 behavior score and clinically significant contamination obsessions, contamination compulsions, and pre-COVID-19 to current change in obsessive-compulsive symptom scores. RESULTS: The COVID-19 behavior score was significantly associated with contamination obsessions (odds ratio (OR) = 1.15, 95% CI = 1.12-1.16; p < 0.001) and contamination phobias (OR = 1.14, 95% CI = 1.12-1.16; p < 0.001). The COVID-19 behavior score also was associated with pre-pandemic to current increase in the overall obsessive-compulsive symptom score (OR = 1.16, 95% CI = 1.09-1.23; p < 0.001), as well as increase in obsessive-compulsive symptom score excluding washing items (OR = 1.13, 95% CI = 1.07-1.19; p < 0.001). The magnitude of these relationships did not appreciably change, after adjustment for other variables associated with the outcomes. Moreover, the relationship was significant in those with or without OCD, and in individuals with different levels of doubt and COVID-19 risk. CONCLUSIONS: Contamination safety measures are critical for reducing the spread of COVID-19 in the community. However, they may be related to the development of contamination-related symptoms and OCD in vulnerable individuals, complicating the diagnosis and treatment of mental disorders during this period.

Obsession with Covid-19 in Peruvian police and armed forces: Validation of the obsession with Covid-19 Scale in Spanish using SEM and IRT models.

The study evaluated the psychometric properties of the Spanish version of the Obsession with COVID-19 Scale (OCS) in 214 police and members of the armed forces (Mage = 29.33 years, SD = 11.28). The one-dimensionality and satisfactory reliability of OCS were confirmed with confirmatory factor analysis, Item Response Theory analysis, Cronbach's alpha, and McDonald's omega. The scale is useful for identifying individuals with low levels of persistent and disturbing thoughts about COVID-19. COVID-19 obsession was associated with COVID-19 fear, anxiety, and depression. The OCS is suitable for investigating the psychological impact of COVID-19 on members of the police and armed forces.

Understanding wellbeing and death obsession of young adults in the context of Coronavirus experiences: Mitigating the effect of mindful awareness.

The present study investigated the mediating effect of mindfulness on the association of coronavirus-related suffering and stress with death obsession and subjective wellbeing in young adults during the COVID-19 pandemic. The sample of this study was 583 Turkish young adults from a public university in Turkey. They ranged in age between 18 and 40 years (M = 20.97; SD = 2.38). The results showed that coronavirus stress mediated the impact of coronavirus suffering on mindfulness and death obsession. Moreover, greater mindfulness mediated the adverse impacts of coronavirus suffering and stress on young adults' subjective wellbeing.

Validation of the Brazilian Portuguese version of the Obsession with COVID-19 Scale (BP-OCS) using a large University Sample in Brazil.

We aimed to validate a Brazilian Portuguese version of the Obsession with COVID-19 Scale (BP-OCS) using a large sample of university students in Brazil (N = 1454). The scale showed solid psychometric characteristics in terms of internal consistency (α = .78), test-retest reliability (ICC = .86), factorial validity (PAF and CFA support), and construct validity. Additionally, BP-OCS scores were found to be higher among females, participants with diagnosed depression, anxiety, and self-reported anxiety. These findings suggest that the BP-OCS is a reliable and valid measure of persistent and disturbed thinking about COVID-19 for Brazilian university students.

Validation of the Korean version of the obsession with COVID-19 scale and the Coronavirus anxiety scale.

In response to the current COVID-19 pandemic, the Obsession with COVID-19 scale (OCS) and the Coronavirus Anxiety Scale (CAS) were developed as screening tools for dysfunctional anxiety associated with the coronavirus. These scales have not yet been validated in the East Asia. The present study examined the validity of the OCS and the CAS with a sample of 329 Korean adults. We found that the OCS-Korean and CAS-Korean showed good psychometric properties and construct validity. Developing such valid screening tools across different cultures is vital for health practitioners and scholars alike during global infectious disease outbreaks.

Exacerbation of obsessive compulsive disorder symptoms in children and adolescents during COVID-19 pandemic.

OBJECTIVE: To investigate the effects of COVID-19 pandemic and related home confinement on symptom profile, symptom severity and exacerbation of obsessive compulsive disorder (OCD) symptoms and related factors among young subjects with OCD. METHOD: Young subjects who have been followed up with a primary diagnosis of OCD in a university hospital were reached by telephone or online programs to assess symptom profile, symptom severity and exacerbation during pandemic. Children's Yale-Brown Obsessive Compulsive (CY-BOCS) and Clinical Global Impression- Severity (CGI-S) Scales were used to rate symptom profile and severity before pandemic and during pandemic periods. RESULTS: There was a significant increase in the frequency of contamination obsessions (p=0.008) and cleaning/washing compulsions (p=0.039) during pandemic period. CY-BOCS obsessions (p<0.001), compulsions subscales (p<0.001) and total scores (p<0.001), and CGI-S scores (p<0.001) during pandemic period were statistically higher than before pandemic period. There was a significant relationship between the change in CY-BOCS scores with talking/searching in the social environment about COVID-19, daily preoccupation about COVID-19, duration of OCD diagnosis and diagnosis of COVID-19 in someone familiar. CONCLUSIONS: Young subjects with OCD may develop additional symptoms and worsen already existing symptoms of OCD during COVID-19 pandemic.

Psychological aspects of COVID-19.

BACKGROUND: COVID-19 pandemic has affected the world from every aspect. Individuals are drained from social, financial, and emotional percussion of this pandemic. Psychosocial consequences are far greater than are being perceived. It is anticipated that once the pandemic is over the psycho-emotional turbulence would shake the whole populations of affected countries. AIMS AND OBJECTIVES: To review the psychological consequences of COVID-19 pandemic. METHODS: A literature search was conducted on major databases from January 2020 to April 2020 with the search terms of Covid-19, Corona virus, psychological, depression, anxiety, phobias, obsessive behaviors, paranoia, parental relationship, marital life and maternal and fetal bond. CONCLUSION: Patients with COVID-19 infection are more likely to suffer from a myriad of psychological consequences, and this infection may have profound effect on parenting, relationships, marital life, elderly, and maternal-fetal bond.