Stressful Life Events and the Clinical Expression of Obsessive–Compulsive Disorder (OCD): An Exploratory Study

Abstract

Background: In obsessive–compulsive disorder (OCD), symptom content and severity appear to fluctuate over the course of the life cycle in accordance with stressful life events. The objective of this paper was to compare OCD patients with and without reported stressful life events (SLEs) in terms of the sociodemographics of patients and the clinical characteristics of OCD. Methods: This was a cross-sectional study involving 1001 patients with OCD. Data concerning SLEs were collected via the Yale OCD Natural History Questionnaire, while for OCD symptoms, the Dimensional Yale–Brown Obsessive–Compulsive Scale was used. Results: Of the 1001 OCD patients, 605 (60.5%) reported experiencing at least one SLE in their lifetime. Self-declared nonwhite skin color (odds ratio (OR) = 1.51), the presence of a sensory phenomenon (OR = 1.47), and comorbidity with post-traumatic stress disorder (PTSD) (OR = 2.38) were some of the logistic regression variables related to the reported SLEs with relevant statistical significance and risk (i.e., OR) values. Conclusions: Our results indicate that SLEs may make Brazilian OCD patients vulnerable to the onset or exacerbation of obsessive–compulsive symptoms. The positive association of the occurrence of SLEs and sensory phenomena in this population could corroborate that environmental influences impact the neurobiology associated with OCD, and likely with other psychiatric disorders as well.

Investigating the correlation between perceived stress and health anxiety with obsessive–compulsive disorder and quality of life during COVID-19 pandemic

“…There were significant correlations between obsessions about dirt, germs and viruses, and between those who engaged in compulsive hand washing and the likelihood that respondents had moderate/high stress. Increased general stress (for example, job loss and family disease) and changes in normal life routines are among the causes of severe obsessive–compulsive symptoms [ 50 ], and it is true about COVID-19 and the quarantine caused by it.…”

The perceived long-term impact of COVID-19 on OCD symptomology

“…This result may indicate that most dimensions of OCD have been negatively impacted by the pandemic, but some forms more significantly than others ( Wheaton et al, 2021 ). It is possible that any stressful life event could lead to a generalized increase in OCD severity ( Kracker Imthon et al, 2020 ). However, when assessing unique predictors, it was found that only higher scores on the contamination subscale were linked to COVID-19 concern and impairment by the pandemic, which is to be expected given the fears associated with this dimension.…”

SAPAP3, SPRED2, and obsessive-compulsive disorder: the search for fundamental phenotypes

“…In those with more marked alterations in these processes, a transition to clinical OCD occurs (Poletti et al, 2022b ). This may be more likely to happen at “critical” stages of the life cycle, or at any other period characterized by increased stress and a higher cognitive, affective or sensory load (Sousa-Lima et al, 2019 ; Imthon et al, 2020 ; Raposo-Lima and Morgado, 2020 ). Such periods include the transition from early to later childhood (Geller et al, 2001 ), the transition from adolescence to adulthood (Horwath and Weissman, 2000 ; Solmi et al, 2022 ), and pregnancy or childbirth in women (Starcevic et al, 2020 ).…”