A recent study conducted in the Department of Psychology at the Hebrew University during the general lockdown imposed following the outbreak of the Corona during April 2020 examined these claims scientifically.
With the outbreak of the Corona epidemic, a number of opinion articles were published in the press and in the professional literature which predicted that people dealing with obsessive-compulsive disorder (OCD) will experience more difficulties compared to the general population and will experience significant symptomatic worsening during the crisis. For example, an article published in March 2020 in the Guardian newspaper predicted a sharp increase in both the number of people diagnosed with OCD and the severity of the symptoms of those dealing with OCD following the crisis. These predictions were based on the fact that some of those dealing with OCD are compulsively preoccupied with the contents of pollution and cleanliness, therefore they predicted that a global epidemic would awaken the distress associated with pollution and increase their need for cleanliness. A recent study conducted in the Department of Psychology at the Hebrew University during the general lockdown imposed following the outbreak of the Corona during April 2020 examined these claims scientifically.
The study was conducted under the leadership of Dr. Eyal Kalantroff, Prof. Yonatan Hapert and doctoral students Hadar Naftalovich and Ran Litman, and published in the journal "Psychiatry And Clinical Neurosciences". 65 OCD sufferers took part in the study. The study participants described in an online survey the intensity of their OCD symptoms and also the type of symptoms they are dealing with (such as symptoms of contamination, order, morality, etc.). They were also asked to describe how their OCD symptoms had been affected over the past two weeks – whether they had gotten worse, improved, or remained the same. Finally, the participants were asked to describe other characteristics they experienced, such as whether they feel feelings of stress, anxiety or depression following the corona crisis.
Two notable findings emerged from the study. First, the number of participants who reported a worsening of symptoms was the same as the number of participants who reported an improvement in symptoms, and similar to the number of participants who reported no change in symptoms (21, 21 and 23 respectively) - so in fact most of the participants No symptomatic worsening was experienced. This division into three equal parts remained even when the participants were divided according to the type of symptoms they were dealing with (infection, order, etc.). This is especially interesting and surprising in participants with symptoms that revolve around infection, so even in this population the majority of participants No symptomatic aggravation was experienced.
Symptomatic aggravation
Second, the research participants answered a series of questions in order to understand what are the unique characteristics of those dealing with OCD who experienced symptomatic exacerbation. Among other things, variables such as age, gender, the degree of depression, the degree of anxiety and the degree of stress experienced by the participants were tested. The only two characteristics that predicted symptomatic worsening are the degree of anxiety and the degree of stress of the participants - that is, the more stress and anxiety the participant experienced during the corona crisis, the more he was expected to experience worsening of OCD symptoms. "However, it is important to understand that anxiety and stress are not unique characteristics of OCD, and also people who do not suffer from any disorders experience on average more stress and anxiety accompanied by various symptoms following the current crisis. In people dealing with OCD, the increase in anxiety and stress was accompanied by a worsening of the symptoms ofOCD ", the researchers explain.
The findings of the study indicate that not every person dealing with OCD, and even with OCD focused on the contents of pollution and cleanliness, will experience symptomatic aggravation in the face of a reality in which a global epidemic does constitute a real health threat and requires extreme adherence to the rules of hygiene and cleanliness. These findings are surprising in view of the gloomy predictions heard about OCD patients, for whom the corona crisis was supposed to be the fulfillment of their worst fears.
The contradiction between the predictions and the research findings is less surprising among some of those dealing with OCD as well as for some of the researchers of the disorder and those who treat it. Unlike the stereotypical image of a person who is constantly busy with cleaning operations, the experience of many of those dealing with OCD is a complex and subjective experience. Those dealing with OCD often experience feelings of distress and the need to perform compulsive rituals in response to triggers that are personally relevant to them, and not necessarily in response to realistic triggers. For example, the need to carry out a compulsive cleaning operation may arise strongly following a thought that occurred to a person that he is polluted, but not arise at all at the sight of a pile of garbage on the street or due to the outbreak of a global epidemic. These characteristics of the OCD disorder may explain, at least partially, why the majority of the study participants did not experience symptomatic worsening despite the great change that occurred in the objective reality. However, since the links between OCD and the effects of the corona epidemic have not yet been studied, there is a need for more studies that will examine the long-term effects of the crisis on OCD patients as well as the influence of other relevant factors that have not yet been examined.
Most OCD patients preferred to come to the clinic despite the possibility of online appointments
"The findings also correspond well with our experiences as clinicians treating patients OCD" The researchers conclude. "In the long months since the outbreak of the corona crisis, the vast majority of patients with OCD They continued to come to clinic meetings even though they were given the option to switch to online meetings, continued to be busy with the same content that they tend to engage in compulsively, and in general were hardly bothered by the various aspects of the Corona crisis. To use the words of one of our patients in response to the question of how he is dealing with the crisis: 'I would very happily get infected with Corona if it would only stop my thoughts that do not leave me for a moment.'"
According to the researchers, these findings also show the importance of understanding the unique difficulties of those dealing with OCD within the framework of mental health care and while avoiding the use of stereotypical assumptions about their dealings with external triggers in general and during the Corona crisis in particular.
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