Prevalence and predicors of COVID-centred obsessive compulsive disorder among Iranian COVID-19 recovered individuals: a Bayesian analysis.

BACKGROUND: The evidence on the psychological consequences of coronavirus 2019 mainly relates to general psychiatric problems, and a few studies have reported the incidence and predictors of obsessive-compulsive disorder. OBJECTIVE: To determine the prevalence of obsessive-compulsive disorder (OCD) and its predictors in Iranian COVID - 19 recovered individuals at 3-6 months, 6-12 months, and 12-18 months after recovery. METHOD: In this cross-sectional analytical study, 300 participants were randomly selected based on the inclusion criteria from three hospitals in three different regions of Tehran, Iran, and were assessed by the Clinical Demographic Information Questionnaire, the Obsessive Compulsive Inventory-Revised (OCI-R), the Depression, Anxiety and Stress Scale 21 (DASS21), The Pittsburgh Sleep Quality Index (PSQI) and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). The obtained data were analyzed with SPSS version 26. RESULTS: The results showed that the mean score of OCD is 30.58 ± 15.22, with a prevalence of 71% (n = 213). Female gender (BF = 0.50, p = 0.01), sleep disturbance (BF = 0.02, p = 0.001), PTSD (BF = 0.009, p = 0.0001), depression (BF = 0.0001, p = 0.0001), and stress (BF = 0.0001, p = 0.001) are the strongest predictors of the presence of OCD in recovered COVID - 19 individuals. CONCLUSION: OCD-like symptoms was observed in the majority of COVID - 19 recovered individuals with mild to moderate severity. In addition, the stated prevalence, severity, and significance varied according to sociodemographic and health inequalities.

The relationship between fear of Covid-19 and obsessive-compulsive disorder.

BACKGROUND: The coronavirus pandemic and health measures related to it have led to an increase in mental health problems. The relatively high incidence of the disease and its mortality rate created anxiety in society. This study aimed to determine the prevalence of fear of the coronavirus (COVID-19) and its relationship with obsessive-compulsive disorder in patients who attended the outpatient clinic of Besat Hospital in Hamadan. METHODS: In this cross-sectional descriptive study, 320 patients who attended the outpatient clinic of Besat Hospital in Hamadan were selected by random sampling method in 2021. Data were collected using the Fear of the coronavirus (COVID-19) questionnaire and obsessive-compulsive disorder scale and analyzed using SPSS software (V16). They were analyzed using Pearson correlation coefficient and independent t-test. RESULTS: The mean ± SD age of the subjects was 34.14 ± 9.30 years and 65% of the study subjects were women. The mean ± SD score on the obsessive-compulsive disorder scale was 32.90 ± 19.87 and the mean ± SD score for fear of coronavirus was 16.82 ± 5.79. The contamination dimension of OCD had the highest score of 9.04 ± 5.46 and stealing had the lowest score of 0.10 ± 0.49. The mean fear of COVID-19 in people who had a history of obsessive-compulsive disorder before the quarantine was significantly higher than in those who did not have it (P = 0.002). Along with the increasing fear of coronavirus scale score, the score of obsessive-compulsive disorders increased except for the stealing dimension (P < 0.001). CONCLUSIONS: The results of the study showed that there was a moderate level of fear of COVID-19 among the study population. Also, a relatively high proportion of study subjects had a weak manifestation of OCD. It seems that two years after the beginning of the Covid-19 coronavirus pandemic, people have adapted to the conditions, and their fear of the disease is reduced.

Inflammatory neuropsychiatric disorders and COVID-19 neuroinflammation.

Neuropsychiatric sequalae to coronavirus disease 2019 (COVID-19) infection are beginning to emerge, like previous Spanish influenza and severe acute respiratory syndrome episodes. Streptococcal infection in paediatric patients causing obsessive compulsive disorder (PANDAS) is another recent example of an infection-based psychiatric disorder. Inflammation associated with neuropsychiatric disorders has been previously reported but there is no standard clinical management approach established. Part of the reason is that it is unclear what factors determine the specific neuronal vulnerability and the efficacy of anti-inflammatory treatment in neuroinflammation. The emerging COVID-19 data suggested that in the acute stage, widespread neuronal damage appears to be the result of abnormal and overactive immune responses and cytokine storm is associated with poor prognosis. It is still too early to know if there are long-term-specific neuronal or brain regional damages associated with COVID-19, resulting in distinct neuropsychiatric disorders. In several major psychiatric disorders where neuroinflammation is present, patients with abnormal inflammatory markers may also experience less than favourable response or treatment resistance when standard treatment is used alone. Evidence regarding the benefits of co-administered anti-inflammatory agents such as COX-2 inhibitor is encouraging in selected patients though may not benefit others. Disease-modifying therapies are increasingly being applied to neuropsychiatric diseases characterised by abnormal or hyperreactive immune responses. Adjunct anti-inflammatory treatment may benefit selected patients and is definitely an important component of clinical management in the presence of neuroinflammation.

Investigating the correlation between perceived stress and health anxiety with obsessive-compulsive disorder and quality of life during COVID-19 pandemic.

BACKGROUND AND AIMS: The present study aimed to investigate the correlation between perceived stress and health anxiety with obsessive-compulsive symptoms and quality of life during COVID-19 pandemic. METHODS: This cross-sectional study was performed in the general public in Isfahan and Bandar Abbas. 559 citizens were selected by convenience sampling. An online questionnaire was used to collect the data, which consisted of: short health anxiety inventory, perceived stress scale, world health organization quality of life questionnaire and Padua inventory. Data analysis was performed using SPSS-24 and Amos-21. RESULTS: There were significant positive correlations between health anxiety and perceived stress (r = 0/338), obsessive-compulsive symptoms and perceived stress (r = 0/16), obsessive-compulsive symptoms and health anxiety (r = 0/344). Also there were significant negative correlations between obsessive-compulsive symptoms and quality of life (r = - 0/21), health anxiety and quality of life (r = - 0/366), perceived stress and quality of life (r = - 0/715). CONCLUSION: health anxiety and perceived stress during COVID-19 affect the obsessive-compulsive symptoms and quality of life. Therefore, it is recommended to pay attention to these psychological disorders during this global crisis and take actions to prevent and treat them.

Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder: a clinical case report.

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a common and chronic psychiatric disorder with significant morbidity characterized by intrusive, uncontrollable and reoccurring thoughts (i.e., obsessions) and/or ritualistic behaviours (i.e., compulsions). Conradi-Hünerman-Happle Syndrome (CHHS) is a rare inherited X-linked dominant variant of chondrodysplasia punctata, a heterogeneous group of rare bone dysplasias characterized by punctate epiphyseal calcifications of complex etiology and pathophysiology that remain to be defined. Available literature reveals a lacuna in regards to the coexistence of the entities with no clinical reports described. CASE PRESENTATION: A 12 year old female patient with diagnosis of CHHS, presents to psychiatric consultation due to aggravation of her OCD clinical picture, with aggravation of hand-washing frequency during the Covid-19 pandemic with significant functional impact. Psychopharmacological treatment aimed at OCD with Selective Serotonin Reuptake Inhibitor (SSRI) and antipsychotic was instituted with favourable, albeit partial response. CONCLUSIONS: The authors aim to describe a clinical case in which the patient presents with Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder. Clinical descriptions of CHHS and OCD are not available in the literature. Through this case description the authors aim to present a rare case as well as discuss an eventual association between etiology and/or pathophysiology of the two disorders.

Prevalence of post-COVID symptoms of obsessive-compulsive disorder in Saudi Arabia.

OBJECTIVES: To determine the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms in patients who have survived COVID-19. METHODS: The study used an observational cross-sectional design between July and October 2021. The target population was adult patients who had confirmed COVID-19 infection prior to joining the study, OCD symptoms were assessed using the Arabic OCD scale created by Abohendy and colleagues, which included 83 questions covering 12 different domains and was administired online. RESULTS: A total of 356 patients were included in the analysis. Approximately 9.0% and 1.7% of the patients had a history of psychiatric disease and OCD diagnosis (respectively). The total symptom score was 32.8%. The most frequently reported domains were rumination of ideas (55.5%), re-checking compulsions (37.0%), and slowness (34.0%), while the least frequently reported domains included obsessive impulses (26.3%), obsessive images (26.5%), and religious compulsions (26.8%). Unlike other domains, the purity and cleanliness compulsions scores were significantly higher than the scale reference population. A higher total symptom score was observed in psychiatric patients (p=0.004) and, to a lesser extent, in OCD patients (p=0.250). CONCLUSION: Overall, OCD symptoms, including cleanliness and fear of disease obsessions, tend to be higher in psychiatric and OCD patients, these findings are valuable for future studies.

Prevalence of obsessive-Compulsive symptoms and the level of fear due to COVID-19 pandemic among the undergraduate medical students in a tertiary care unit in Southern India.

Background: The emergence of COVID-19 and its consequences is causing widespread fears, anxiety, and worries. To overcome the transmission of COVID-19, people resorted to compulsive behaviors. Objectives: The objectives of this study were to assess the prevalence of obsessive-compulsive symptoms (OCSs) due to COVID-19 pandemic, the prevalence of level of fear due to COVID-19 pandemic, and to assess the factors associated with OCSs due to COVID-19 pandemic among the undergraduate medical students of in tertiary unit in Southern India. Methods: The cross-sectional study was conducted in 250 undergraduate medical students (both MBBS and BDS, from 1st to 4th year) in the institute. Students who had consented in the study were included as study participants. The Yale-Brown Obsessive-Compulsive Scale and Fear of COVID-19 Scale (FCV-19 S) were used in assessing OCSs and the level of fear due to COVID-19. Chi-square test and multiple logistic regression were used to compute the factors associated with OCS. Results: The mean age of the respondents was 21 ± 1.313 years. The prevalence of OCS in undergraduate medical students was 36 (14.4%), and the level of FCV-19 was 107 (42.8%). Male students (17.8%, 44.2%) had higher OCSs and levels of fear as compared to female students (13.6%, 42.4%). Students with FCV-19 were three (adjusted odds ratio-3.418, 95% confidence interval-1.596, 7.319) times more likely to manifest OCSs while factors such as age, gender, and course were not significantly associated with OCS. Conclusion: Psychological counseling for undergraduate students should be pivotal, especially during pandemics and outbreaks.

Incidence rate of psychiatric disorders in 2020: The pivotal role played by SARS-CoV-2 infection.

IMPORTANCE: The Coronavirus Disease (COVID-19) pandemic has significantly impacted mental health outcomes. While the frequency of anxiety and depressive symptoms has increased in the whole population, the relationship between COVID-19 and new psychiatric diagnoses remains unclear. OBJECTIVE: To compare the population incidence rate of emergence of de novo psychiatric disorders in 2020 compared to the previous years, and to compare the incidence rate of new psychiatric disorder diagnoses between people with vs without COVID-19. DESIGN, SETTING, AND PARTICIPANTS: This study utilized administrative claims data from the Clinformatics® Data Mart database, licensed from Optum®. The study is a cross-sectional analysis that compared the incidence rate of new psychiatric disorders in 2020 vs. 2018 and 2019 in the entire insured population database. Subsequently, the incidence of new psychiatric disorders in people with vs. without COVID-19 during 2020 was analyzed. EXPOSURE: The exposures included diagnosis and severity of COVID-19 infection. MAIN OUTCOMES MEASURES: The dependent variables of interest were the incidence rates of new psychiatric disorders, specifically schizophrenia spectrum disorders, mood disorders, anxiety disorders, and obsessive-compulsive disorder. RESULTS: The population studied included 10,463,672 US adults (mean age 52.83, 52% female) who were unique people for the year of 2020. Incidence of newly diagnosed psychiatric disorders per 1,000 individuals in the 2020 whole population were 28.81 (CI: 28.71, 28.92) for anxiety disorders, 1.04 (CI: 1.02, 1.06) for schizophrenia disorders, 0.42 (CI: 0.41, 0.43) for OCD and 28.85 (CI: 28.75, 28.95) for mood disorders. These rates were not significantly higher than 2018 or 2019. When comparing incidence rates between COVID-19 vs. non-COVID-19 populations in 2020, the rates were significantly higher in the COVID-19 population: 46.89 (CI: 46.24, 47.53) for anxiety, 49.31 (CI: 48.66, 49.97) for mood disorders, 0.57 (CI: 0.50, 0.65) for OCD, and 3.52 (CI: 3.34, 3.70) for schizophrenia. COVID-19 severity was significantly associated with new diagnoses of schizophrenia, anxiety and mood disorders in multivariate analyses. CONCLUSIONS: Compared to 2018 and 2019, in 2020 there was no increased incidence of new psychiatric disorders in the general population based on insurance claims data. Importantly, people with COVID-19 were more likely to be diagnosed with a new psychiatric disorder, most notably disorders with psychosis, indicating a potential association between COVID-19 and mental/brain health.

Obsessive-Compulsive Disorder During the Initial Stage of COVID-19 Pandemic: Effect of Contamination Symptoms and Poor Insight on Obsessive-Compulsive Disorder Exacerbation.

ABSTRACT: We aimed to investigate the effect of the COVID-19 pandemic on the symptom severity and dimensions of obsessive-compulsive disorder (OCD) and how patients with different levels of insight have been impacted by the pandemic. This study included 58 patients with OCD. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS)-Obsession, Y-BOCS-Compulsion, and Y-BOCS-Total scores during the pandemic were significantly higher than the prepandemic scores (p = 0.001, p < 0.001, p = 0.002, respectively). Compared with the pre-COVID-19 period, severity of OCD symptoms increased in 39.7% patients, remained the same in 44.8% patients, and reduced in 15.5% patients during the pandemic. The obsession with contamination, Brown Assessment of Beliefs Scale (for insight assessment) score, and time spent following the news/data about COVID-19 were significantly associated with an increase in OCD severity. In patients with contamination obsessions as well as poor insight, close monitoring and facilitating access to treatment may reduce the negative impact of the COVID-19 pandemic.

Obsessive-compulsive symptoms among the general population during the first COVID-19 epidemic wave in Italy.

This study investigated obsessive-compulsive symptoms (OCS) in the Italian general population during the initial stage of the pandemic and the impact of COVID-19 related potential risk factors. A web-based survey was spread throughout the internet between March 27th and April 9th, 2020. Twenty thousand two hundred forty-one individuals completed the questionnaire, 80.6% women. The Dimensional Obsessive-Compulsive Scale (DOCS) was included to assess the severity of the obsessive-compulsive symptom domains. Further, selected outcomes were depression, anxiety, insomnia, perceived stress, and COVID-19 related stressful life events. A panel of logistic or linear regression analyses was conducted to explore the impact of COVID-19 related risk factors, socio-demographic variables, and mental health outcomes on OCS. A total of 7879 subjects (38,9%) reported clinically relevant OCS. Specifically, more than half of the sample (52%) reported clinically relevant symptoms in the Contamination domain, 32.5% in the Responsibility domain, 29.9% in the Unacceptable thoughts domain, and 28.6 in the Symmetry/Ordering domain. Being a woman was associated with OCS, except for Symmetry/Ordering symptoms. A lower education level and younger age were associated with OCS. Moreover, depression, anxiety, perceived stress symptoms, insomnia, and different COVID-19 related stressful events were associated with OCS. We found high rates of OCS, particularly in the contamination domain, in the Italian general population exposed to the first COVID-19 epidemic wave and COVID-19 related risk factors. These findings suggest the need to investigate further the trajectories of OCS in the general population along with the long-term socio-economic impact of the pandemic.

Parental surveillance of OCD and mental health symptoms during COVID-19: A longitudinal study of Australian children, adolescents and families.

To ensure the needs of children and families are met for the remainder of the COVID-19 situation and beyond there is a demand for a specific response strategy. This longitudinal study will investigate the impact of COVID-19 on Australian parental and childhood mental health symptoms, particularly OCD symptoms, examining the stability of this relationship over time and the needs and preferences for mental health support in response to child symptoms. A total of 141 parents completed a questionnaire during the lockdown period in Australia (June-September 2020). Thirty-five of them completed a follow-up questionnaire during the post-lockdown period (November 2020-January 2021). The questionnaire assessed COVID-19 experiences/worries/knowledge, child OCD, and child/parental anxiety and depression. Sub-samples of youth were determined based on parent-report of an existing diagnosis of any mental health (n = 24), of OCD (n = 22), or no mental health diagnosis (i.e., healthy, n = 81). Results: Parents reported a significant positive association between increased parental worries regarding COVID-19, and their own as well as their child's mental health symptoms. The current sample of children experienced elevated symptom severity for OCD symptoms during COVID-19. The OCD group reported significant reductions in child OCD symptoms at post-lockdown. The any mental health diagnosed children are at greater risk of developing OCD symptoms and reported strong preferences for increased support as a result. The exploratory nature of this study adds further insight into the impact of the COVID-19 pandemic on child OCD and parent mental health symptoms and the stability of symptoms over time.

COVID-19 Vaccines and Potential Implications for COVID-19-Specific Obsessive-Compulsive Disorder Presentations.

Public health crises, including the ongoing COVID-19 pandemic, have wide reaching implications on mental health, and have resulted in unique OCD presentations specific to respective crises. The distribution of highly efficacious and effective vaccines for COVID-19 present a crossroads for the COVID-19-specific OCD presentation, including the potential for COVID-19 presentation perpetuation or remission in the face of vaccinations. Individual differences may play a unique role in who does and does not see a reduction of OCD symptoms specific to this virus as a function of vaccination status. Here, we discuss prior health crises that have resulted in unique OCD presentations, review relevant assessment and intervention guidelines, discuss potential implications that vaccines may have on this COVID-19-specifc presentation, and provide case presentations and future recommendations for treatment providers and researchers.

The Acute Impact of the Early Stages of COVID-19 Pandemic in People with Pre-Existing Psychiatric Disorders: A Systematic Review.

People with pre-pandemic health conditions are more vulnerable and more likely to suffer greater psychosocial impact due to the current COVID-19 pandemic and the lockdown measures. Thus, the objective of this work was to systematically review the impact of the early stages COVID-19 pandemic on people with pre-existing psychiatric disorders. The search was performed between 23 January and 2 September 2021 in PubMed, PsycINFO, and EMBASE. A total of 4167 published results were identified; however, only 49 were included in this review. Results show that there was considerable heterogeneity among studies, which resulted in a low consensus. However, it seems that the impact of the first stage of the COVID-19 pandemic on psychiatric disorders was two-fold: (1) an overall effect, in which people suffering from psychiatric disorders in general experienced more psychological distress and anxiety when compared to people who had no psychiatric diagnosis, and (2) a condition-specific effect, namely in people suffering from eating disorders and obsessive compulsive disorders. Moreover, the current work highlights that there were also some external factors that were related to worsening symptoms. For instance, unemployment or experiencing work and financial difficulties can be a trigger for greater distress during the pandemic for people with mood disorders, and being alone and in social isolation during the COVID-19 pandemic may actually increase substance use and relapse rates. Further studies are needed to prospectively investigate the long-term effects of the current COVID-19 pandemic on people with (pre)-existing psychiatric conditions and on the onset or deterioration of psychiatric-related symptoms in a larger number of participants, as well as exploring the long-term effects of the current pandemic on mental health.

The immediate and long-term impacts of the COVID-19 pandemic on patients with obsessive-compulsive disorder: A one-year follow-up study.

Several recent publications have revealed that obsessive-compulsive disorder (OCD) patients were adversely affected during coronavirus disease 2019 (COVID-19); however, how long this negative impact will last is unclear. Our study aimed to investigate the impact of the COVID-19 pandemic on OCD patients after one year. Online questionnaires were administered, and clinical interviews were conducted to assess OCD symptoms, depression, anxiety, information about COVID-19 and mental resilience at baseline (1 December 2019-1 January 2020), during early COVID-19 (26 February-25 March 2020) and at the one-year follow-up (26 February-25 March 2021). A total of 110 OCD patients were enrolled. Our findings showed that OCD, depressive and anxiety symptoms worsened during early COVID-19, and the negative impact persisted at the one-year follow-up. Multivariate analysis showed that female gender, concern about COVID-19 and OCD symptom severity at baseline were risk factors for exacerbation of OCD symptoms during early COVID-19, while optimism, as one composite factor of resilience, was a protective factor against exacerbation of OCD symptoms both during early COVID-19 and at follow-up. Our study showed that COVID-19 had immediate and long-term impacts on the exacerbation of OCD symptoms, and interventions targeted at improving resilience are recommended.

Mental health and perceived impact during the first Covid-19 pandemic year: A longitudinal study in Dutch case-control cohorts of persons with and without depressive, anxiety, and obsessive-compulsive disorders.

BACKGROUND: Little is known about the longer-term impact of the Covid-19 pandemic beyond the first months of 2020, particularly for people with pre-existing mental health disorders. Studies including pre-pandemic data from large psychiatric cohorts are scarce. METHODS: Between April 2020 and February 2021, twelve successive online questionnaires were distributed among participants of the Netherlands Study of Depression and Anxiety, Netherlands Study of Depression in Older Persons, and Netherlands Obsessive Compulsive Disorder Association Study (N = 1714, response rate 62%). Outcomes were depressive symptoms, anxiety, worry, loneliness, perceived mental health impact of the pandemic, fear of Covid-19, positive coping, and happiness. Using linear mixed models we compared trajectories between subgroups with different pre-pandemic chronicity of disorders and healthy controls. RESULTS: Depressive, anxiety and worry symptoms were stable since April-May 2020 whereas happiness slightly decreased. Furthermore, positive coping steadily decreased and loneliness increased - exceeding pre-Covid and April-May 2020 levels. Perceived mental health impact and fear of Covid-19 fluctuated in accordance with national Covid-19 mortality rate changes. Absolute levels of all outcomes were poorer with higher chronicity of disorders, yet trajectories did not differ among subgroups. LIMITATIONS: The most vulnerable psychiatric groups may have been underrepresented and results may not be generalizable to lower income countries. CONCLUSIONS: After a year, levels of depressive and worry symptoms remained higher than before the pandemic in healthy control groups, yet not in psychiatric groups. Nevertheless, persistent high symptoms in psychiatric groups and increasing loneliness in all groups are specific points of concern for mental health care professionals.

Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies.

OBJECTIVE: Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive-compulsive disorder/symptoms (OCD/OCS). During the COVID-19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS. METHOD: In Study 1, we investigated UP in the general population (N = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS-CoV-2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/-) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (N = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS-CoV-2 at the start of the pandemic and re-assessed OCS 3 months later. RESULTS: In Study 1, UP was higher in the OCS+ compared to the OCS- group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS-CoV-2, but not for infection itself. CONCLUSIONS: Exaggeration of one's personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample. PRACTITIONER POINTS: Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well-being in the face of danger or uncertainty. The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive-compulsive disorder and may also be involved in the development of the disorder. This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.