Abstract
The COVID-19 pandemic has created novel mental health challenges for those with pre-existing problems including obsessive-compulsive disorder (OCD). Our study reports on clinician perceptions regarding the effect of the COVID-19 pandemic on patients with OCD receiving exposure and response prevention treatment (ERP) prior to and during the pandemic. Participating clinicians completed a survey which included questions adapted from National Institute of Mental Health-Global Obsessive-Compulsive Scale (NIMH-GOCS) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinicians rated clinical features at treatment initiation, just prior to the pandemic, and mid-pandemic (July/August, 2020). Findings suggest that the COVID-19 pandemic was associated with attenuation of ERP progress from expected rates in most patients during first several months of the pandemic; clinicians estimated that 38% of their patients had symptoms worsen during the pandemic and 47% estimated that symptoms remained unchanged despite participating in ERP. Those who endured financial distress or were medically at-risk for severe COVID-19 disease had worse ERP course. Adults also had a worse ERP course during than pandemic than youth. Further research is needed to better understand the effect of the COVID-19 pandemic on OCD symptomatology and treatment trajectory post-pandemic.
1. Introduction
The novel SARS-CoV-2 coronavirus (and its clinical syndrome, COVID-19) has created lasting social, medical, and psychological consequences since its emergence in December 2019 (Lu et al., 2020). Individuals have taken measures to protect themselves by adhering to official safety guidelines outlined by governmental and public health bodies, which include social distancing, wearing face masks, practicing appropriate hygiene, and maintaining other preventative behaviors (CDC, 2020). Beyond its medical morbidities, the COVID-19 pandemic presents additional challenges for mental health. The pandemic has been associated with worsened mental health for those with pre-existing problems as well as new-onset mental health concerns (Asmundson et al., 2020; Haider et al., 2020; Plunkett et al., 2020).
4. Discussion
We report on clinician perceptions of the impact of the COVID-19 pandemic on individuals with OCD receiving ERP prior to and during the pandemic. Overall, clinicians estimated that over one-third of their patients’ symptoms worsened during the initial period of the COVID-19 pandemic despite continuing in active treatment.
