How are OCD patients and their families coping with the COVID-19 pandemic? A qualitative study

Abstract

Patients with obsessive-compulsive disorder (OCD) are likely to be affected by the COVID-19 crisis since fear of contamination is highly prevalent in this illness and disease reminders are omnipresent during this crisis. The current study aimed to investigate the impact of the pandemic and the lockdown on the mental health, well-being and coping abilities of OCD patients and their families in order to increase our understanding of the underlying mechanisms of the disorder. Twenty-two patients and 13 family members were interviewed one-to-one about their experiences and challenges caused by the pandemic and home-confinement directives. Verbatim transcripts of the interviews were analyzed using inductive thematic analysis. Five overarching themes were identified: (1) changing point of reference: confusion and legitimization of OCD behavior, (2) coping strategies were challenged: too much or too little exposure to obsessional concerns, (3) distress but also relief in some areas, (4) developing a new equilibrium within the family, (5) changes in accessibility and nature of therapy: perils and merits of online treatment. These findings make clear the importance of the accessibility of mental health services during this pandemic through direct patient contacts or in a remote format. In therapy therapists should focus on challenging the changing point of reference, providing practical advice on coping, stimulating to engage in exposure and encouraging patients to seek social support. Furthermore, it is important to involve family members in therapy to support and coach them to be validating, supportive and encouraging, without accommodating to the OCD behaviour.

Resilience predicts positive mental health outcomes during the COVID-19 pandemic in New Yorkers with and without obsessive-compulsive disorder

“…Online studies of people who self-identified as having OCD showed a similarly large range of outcomes, with between 33% and 76% of samples reporting symptom worsening ( Jelinek et al, 2021 ; Littman et al, 2020 ; Wheaton et al, 2021 ). However, Tandt et al (2021) found that after an initial worsening of symptoms, individuals with OCD subsequently experienced symptom improvement, and others found that children ( Schwartz-Lifshitz et al, 2021 ) and some adults ( Littman et al, 2020 ) reported improved functioning months into lockdown.…”

The impact of COVID-19 on obsessive-compulsive disorder - literature review

“…The media guidelines for preventing COVID-19 infection are in line with the obsessions of people with OCD, but contradict the treatment of obsessive-compulsive disorder. In times of pandemic, there is a difficulty between distinguishing standard disinfection techniques and dysfunctional obsessive-compulsive behavior [22]. Researchers became interested in the impact of the pandemic on the course of obsessive compulsive disorder and its prognosis [27].…”

Feelings of Entrapment during the COVID-19 Pandemic Based on ACE Star Model: A Concept Analysis

“…Lockdown system or situation during the COVID-19 [3,6,18,26,29,[35][36][37][38][39][40][41], impairment to social and occupational functioning [9] Restricted situation Social consequences of COVID-19 [3], restrictions [35], physical distancing and self-isolation [36], isolation [29,42], reduced social opportunities [42], social restriction [38], isolation and loneliness/reduced contact with key individuals/ living alone/cessation or reduction of service (including absence of face to face support) [16], limited/restricted [43], social distancing [6,18,29,40,43], losing direct social and physical contact [9], restricted in a situation [44] Uncertain future…”

“…Increased suicide Suicide ideation [3,6], self-harm [15,16], risk factors of suicide [9,14,15,18], suicide [6,29,35,37,42,44], suicidal intent and behavior [47], suicidality [46], suicidal actions and ambivalent to living or dying [6] Decreased mental health Decreased mental health problem [3,16,29,44], feeling isolated and the specific mirroring of abuse [38], foster neglect and abuse [40] Decreased well-being Decreased well-being [3,29], negative wellbeing [36], affect their care and wellbeing [40] (1) Out of control The situation during the COVID-19 pandemic is out of control; an individual's ability to control impulses and modify inappropriate emotions and thoughts [48,49] and the world is desperately exhausted [48]. Out of control is.…”