Contamination fear during the COVID-19 pandemic in patients with lifetime obsessive compulsive disorder and healthy controls: A longitudinal cohort study

Background: The COVID-19 pandemic could be considered a 'symptom provocation test,' which may trigger specific OCD and other psychiatric symptoms. Therefore, we aimed to compare the long-term impact of the pandemic on fear of COVID-19, and contamination, depressive and anxiety symptoms in three groups: individuals with OCD with and without pre-pandemic contamination symptoms and healthy controls.

Methods: From April 2020 to February 2022, we administered 16 online questionnaires on 138 persons with a lifetime diagnosis of OCD and 373 healthy controls. We evaluated outcomes related to fear of COVID-19, cleaning obsessions and compulsions, anxiety, and depressive symptoms. Using mixed models, we compared the trajectories among persons with OCD who had pre-pandemic contamination symptoms, those without such symptoms, and healthy controls.

Results: Pre-pandemic contamination symptoms were significantly associated with higher fear of COVID-19, contamination symptoms, anxiety, and depressive symptoms. Persons with OCD without pre-pandemic contamination symptoms scored, on average, quite similarly to healthy controls.

Conclusions: Only in persons with pre-pandemic contamination symptoms did the pandemic provoke more fear of COVID-19 and contamination symptoms than in controls. It seems that stress caused by external factors, does not tri trigger OCD symptoms unless there is a connection to the subtype of OCD.