How Did Obsessive-Compulsive Disorder Symptoms Change During Different COVID-19 Waves?

What you need to know

• Over one-third of people with OCD experienced worsening symptoms during both the first and second COVID-19 waves
• Older patients were more affected during the second wave compared to the first wave
• Those with worsening symptoms showed increased avoidance behaviors, family accommodation needs, and job difficulties

How the Study Was Done

Researchers followed 116 people with OCD who were receiving care at three specialty clinics in Northern Italy. They compared how these patients were doing during the first COVID-19 wave (early 2020) and the second wave (late 2020 to early 2021). The researchers conducted interviews to assess changes in OCD symptoms, daily functioning, and overall mental health.

Key Findings About Symptom Changes

During both waves, about 37% of patients experienced worsening OCD symptoms. Those who got worse showed several concerning changes:

• New obsessive thoughts and compulsive behaviors emerged
• Old symptoms that had previously improved came back
• They needed more changes to their medication
• They had more trouble sleeping
• They showed more avoidance behaviors (staying away from situations that made them anxious)
• Family members had to provide more help and accommodation
• They had more difficulty with work

Understanding the Impact on Different Groups

The study found some interesting differences between groups:

1. Age Differences

• Older patients were more likely to get worse during the second wave
• This may be because older people had more trouble accessing healthcare services during the pandemic

2. Gender Differences

• Men were more likely to experience return of past obsessive thoughts
• Women were more likely to spend excessive time checking internet news about COVID-19

3. Work Impact

• People with worsening symptoms had more trouble working from home
• They reported more difficulties at work overall

Long-term Effects and Complications

The research revealed several concerning long-term effects:

• Some patients developed thoughts of suicide, though this wasn’t statistically significant
• Many showed increased checking behaviors, especially looking up health information online
• Depression and other mental health conditions became more common
• Sleep problems were significantly more common in those who got worse

Clinical Implications for Treatment

The findings suggest several important considerations for treatment:

• Patients may need more frequent medication adjustments during times of stress
• Online therapy and healthcare access should be made more available to older patients
• Extra support may be needed for work-related difficulties
• Monitoring for depression and suicidal thoughts is important
• Family support and education is crucial

Conclusions

• The COVID-19 pandemic had a sustained negative impact on many people with OCD
• Different groups (older vs younger, men vs women) were affected in different ways
• Healthcare providers should monitor patients closely during times of widespread stress
• Support systems need to be adaptable for different age groups and circumstances