MHM Magazine

Issue 2 | 2021 | MENTALHEALTHMATTERS | 19 MHM pandemic be more prominent than in obsessive-compulsive disorder (OCD). OCD 101 OCD affects approximately 2-3% of adults, suggesting that, in South Africa, there could currently be about 1.2 million people living with this illness. Alarmingly, sub-threshold OCD may have an even higher prevalence. OCD is a debilitating mental disorder that is characterised by recurrent disturbing intrusive thoughts (termed obsessions), and compulsions that involve repetitive and time-consuming behaviours or mental rituals. Some sufferers have intrusive thoughts relating to a fear of contamination. These thoughts are then associated with compulsive cleaning rituals such as repetitive hand washing. Other intrusive fears may be centred around symmetry and order (leading, for example, to ritualistic arranging and organising) or harm-related worries (such as fears of inadvertently hurting someone) followed by constant checking to prevent these bad or harmful things from happening. These are just a few examples of the symptom clusters typically reported by people with OCD. COVID-19 AND ITS IMPACT ON OCD: WHAT DOES THE RESEARCH SAY THUS FAR? In terms of the COVID-19 pandemic, OCD symptoms relating to contamination obsessions and cleaning compulsions are of particular interest. We know that about half of people with OCD present with this type of symptom cluster. While frequent handwashing and sanitising are certainly necessary for preventing the spread of COVID-19, their effects on this subset of individuals with OCD may be a cause for concern. It seems natural that increased anxiety about the virus could worsen existing obsessive fears of contamination and exacerbate compulsive washing and cleaning. Additionally, the global pandemic may even trigger de novo contamination fears in some people with OCD. For example, in Turkey, researchers reported a significant increase in the frequency of contamination obsessions and cleaning compulsions in children and adolescents with OCD during the pandemic compared to before. In adults in Italy, researchers showed an increase in OCD severity, especially with those suffering from the contamination symptom cluster being affected. Worryingly, people with OCD who were in remission before the pandemic also tended to relapse. An online survey among university students in China suggested the intensity of the fear of COVID-19 played a part in OCD symptoms and that the level of lockdown was identified as a possible contributing factor. Findings from the research are mixed however. A study in a Danish cohort of children and adolescents with OCD reported a direct link between COVID-19 and the intensification of obsessive- compulsive symptoms couldn’t be established. A Dutch online survey also didn’t show significant increases in symptom severity in adults with depression, anxiety, or OCD during the pandemic.