Contamination-related behaviors, obsessions, and compulsions during the COVID-19 pandemic in a United States population sample. (June 2021)

• Record Type: Journal Article
• Authors: Samuels, Jack; Holingue, Calliope; Nestadt, Paul S.; Bienvenu, O. Joseph; Phan, Phillip; Nestadt, Gerald
• Is Part Of: Journal of psychiatric research. Volume 138(2021)
• Page Start: 155
• Page End: 162
• Publication Date: 2021-06
• Subjects: Obsessive-compulsive disorder -- Phobia -- Contamination -- COVID-19 -- General population; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2021.03.064
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Background: Contamination-prevention behaviors such as mask wearing and physical distancing are crucial to reduce coronavirus transmission during the COVID-19 pandemic. We hypothesized that engagement in these behaviors could provoke obsessions and phobias in vulnerable individuals in the community. Methods: A total of 2117 participants, systematically selected to represent the age, gender, and race distributions of the US population, completed an online survey that assessed demographic characteristics, clinical features, COVID-19 risks, and COVID-19 contamination-prevention behaviors. Logistic regression was used to estimate the magnitude of the relationships between the COVID-19 behavior score and clinically significant contamination obsessions, contamination compulsions, and pre-COVID-19 to current change in obsessive-compulsive symptom scores. Results: The COVID-19 behavior score was significantly associated with contamination obsessions (odds ratio (OR) = 1.15, 95% CI = 1.12–1.16; p < 0.001) and contamination phobias (OR = 1.14, 95% CI = 1.12–1.16; p < 0.001). The COVID-19 behavior score also was associated with pre-pandemic to current increase in the overall obsessive-compulsive symptom score (OR = 1.16, 95% CI = 1.09–1.23; p < 0.001), as well as increase in obsessive-compulsive symptom score excluding washing items (OR = 1.13, 95% CI = 1.07–1.19; p < 0.001). The magnitude of these relationships did not appreciably change, after adjustment for other variables associated with the outcomes. Moreover, the relationship was significant in those with or without OCD, and in individuals with different levels of doubt and COVID-19 risk. Conclusions: Contamination safety measures are critical for reducing the spread of COVID-19 in the community. However, they may be related to the development of contamination-related symptoms and OCD in vulnerable individuals, complicating the diagnosis and treatment of mental disorders during this period. Highlights: Safety behaviors might provoke psychopathology in some people during COVID-19. We investigated these behaviors in a population-based U.S. sample (N = 2117). These behaviors were associated with contamination obsessions and phobias. These behaviors were associated with increase in OC symptom scores. The findings have implications for treatment of mental disorders during pandemics.