Impact of the COVID-19 Pandemic on the Short-term Course of Obsessive-Compulsive Disorder

Background

There is an understandable concern that obsessive-compulsive disorder (OCD) may worsen during the COVID-19 pandemic, but there is little empirical data. We report the impact of COVID-19 pandemic on the short-term course of OCD. We also assessed for predictors of relapse and emergence of COVID–19–themed obsessive–compulsive symptoms.

Methods

A cohort of patients with a primary diagnosis of OCD (n=240) who were on regular follow-up at a tertiary care specialty OCD Clinic in India were assessed telephonically, about 2 months after the declaration of the pandemic (‘pandemic’ cohort). Data from the medical records of an independent set of patients with OCD (n=207) who were followed–up during the same period, one year prior, was used for comparison (historical controls).

Results

The ‘pandemic’ group and historical controls did not differ in the trajectories of the Yale-Brown Obsessive-Compulsive Scale (YBOCS) scores (Chi-square for likelihood-ratio test of the Group × Time interaction = 2.73, p= 0.255) and relapse rate [21% vs 20%, adjusted odds ratio = 0.81 (95% CI 0.41 -1.59, p=0.535]. Pre-existing contamination symptoms and COVID-19-related health anxiety measured by the COVID-Threat Scale did not predict relapse. Only a small proportion of patients (6%) reported COVID-19-themed obsessive-compulsive symptoms.

Limitations

Follow-up 2 months after pandemic declaration may be too early understand the true impact.

Conclusions

The COVID-19 pandemic, at least in the short-run, did not influence the course of illness in those who were on medications. It would be pertinent to evaluate the long-term impact of the pandemic on the course of OCD.

Highlights