COVID-19 and Its Effects on Obsessive Compulsive Disorder

Our previous articles mentioned the negative effects of Covid-19 on psychiatric disorders. In this article, we will share with you a study, which researched the effects that the Covid-19 pandemic and the associated restrictions had on Obsessive Compulsive Disorder (OCD).

Upon the emergence of the pandemic, the borders were closed, the economy was disrupted, while people isolated themselves at their homes. While global health institutions were having difficulties in finding a solution for the restrictions, the main strategies offered by the World Health Organization (WHO) and the Centers for Disease Control and Prevention were social distancing, hand hygiene, and wearing masks. As hand hygiene is considered to be one of the safest measures against infections, there was a spike in the demand for disinfectants, soaps, and gloves. The media frequently emphasized the important of hygienic measures and hand hygiene in preventing infections.

The strategies announced seem to be easily applicable by people; nevertheless, how easy was it to implement these strategies for patients with obsessive compulsive disorder (OCD) who already have doubts in the issue of hygiene and who need to stay clean?

The importance of the obsessive-compulsive symptoms was substantially overlooked among a number of psycho-social outcomes caused by the COVID-19 outbreak, including panic, health concerns, mass hysteria, and isolation-driven loneliness. We can only guess the extent of the problems caused by this negligence. It has been reported that there is a spike in the complaints regarding OCD-related symptoms, problems, and concerns. Unfortunately, the lack of sensitivity among public health workers towards this mental health problem was among the problems reported.

Of those multiple symptoms, the obsessions related to infection and hand hygiene are the most common ones. Moreover, even though these fields respond to pharmacotherapy and psychotherapy quite well, they tend to recur due to external or environmental reasons. The increase in the symptoms may not be sudden; it may take days or months to fully manifest itself. Various prevalent factors may play a part in deteriorating the symptoms of those who are already being affected during the current pandemic:

1. The need for hand hygiene, as well as the minimum duration recommended for that, may increase.
2. “Proper Steps for Hand Hygiene” may contribute into ritualistic compulsions.
3. After coming home from the outside, one could perform cognitive “justification”, to eliminate the state of “being dirty”, instead of thinking that the need for washing his hands is a problem.
4. Asking the family to impose harsh hygiene measures, or asking for the exact opposite.
5. The constant information fed by various media outlets regarding the possibility of the virus staying active on inanimate surfaces, may contribute into the thoughts on infection.
6. The ruminations, recurrent washings, and exaggerated measures of the person may be “normalized” against the pandemic reaction.
7. It can lead to the stockpiling of soap and disinfectants, the hoarding behavior, or panic shopping.

Uncontrolled obsessions and compulsions can lead to dermatological problems, chronic stress, sleep deprivation, and a high risk of suicide. It is required to be ready for a possible increase in such cases during the ongoing pandemic. Particularly primary care workers need to familiarize themselves with the obsessive-compulsive complaints and be trained to refer patients when needed.

REFERENCES:
– Banerjee, D. (2020). The other side of COVID-19: Impact on obsessive compulsive disorder (OCD) and hoarding. Psychiatry research, 288, 112966.