Some OCD patients may experience a decrease in symptoms during the pandemic, new study finds

Some people with obsessive compulsive disorder may actually experience improvement in symptoms during the pandemic, a small new study out of Belgium finds.

The study, published in Psychiatric Quarterly, looked at how symptoms in people with OCD before March 2020 compared to the start of the COVID-19 crisis, to determine how the pandemic impacted obsessive compulsive behaviours.

Researchers interviewed 49 OCD patients and 26 family members to assess OCD symptom severity, family accommodation, depressive symptoms, specific stress related to the pandemic and stress related to the “waxing and waning” pattern of the pandemic.

The study found that for most of the OCD patients interviewed, symptoms increased at the start of the pandemic and during the first lockdown in Belgium in March 2020, they improved as the pandemic progressed.

Researchers predicted that the slight improvement in OCD symptoms was the result of a number of factors, including feeling safer because other people were practising better hygiene, increased time spent alone and away from OCD triggers, and more free time to develop insight into compulsions and view them as less threatening or serious.

However, the study also found that patients who had increased family accommodation, which involves family members removing triggers, reassuring obsessive habits and taking over, showed increased levels of OCD symptoms.

Family accommodations are widely viewed by researchers as a factor in increasing OCD symptoms and preventing people with OCD from dealing with their behaviour.

Researchers predict that increased stress amongst family members, more time spent at home, and increasing feelings of responsibility towards family members with OCD, have all grown in response to the pandemic thus resulting in more family accommodation and worse OCD symptoms.

However, despite a decrease in OCD symptoms such as habitual actions, the study found that rates of depression, anxiety and stress amongst OCD patients increased across the board during the pandemic.

Other research has shown that despite original beliefs that OCD patients would experience significant increases in symptoms, some people haven’t experienced any changes in thier behaviour since the start of the pandemic.

One study found that while some​ people experienced worsened OCD symptoms during the pandemic, their triggers were not associated with contamination or fear of illness, rather stress and anxiety which often cause obsessive compulsive behaviours.

However, Dr. Evelyn Stewart, a Canadian psychiatrist and professor at the University of British Columbia, who wasn’t involved in the Belgium study, is worried that the improvement some OCD patients have experienced may offer false hope.

“The part that I am concerned about is that it might actually appear like OCD is improving for a number of individuals but that’s not actually true,” says Stewart in an interview with CTV News. “All of a sudden with COVID, it is totally valid and appropriate to be doing a lot of double checking, to be doing extra washing, to actually not go places or be in contact with people if you have concerns about the possibility of contamination, but as things go back to the new normal, whatever it’s going to be, it’s going to be really challenging for individuals with OCD who have contamination worries to go back to the pre-COVID norm and to be able to accept the little bit of risk that’s there.”

Similar to the study’s conclusions, Stewart says that improvement in OCD patients’ symptoms is likely the result of more time spent in isolation, feelings of validation towards washing and hygiene practices and feelings of relief that they no longer need to explain their behaviour.

Stewart says that OCD is focused on certainty and the ability to feel like you’ve done everything you can to keep yourself safe. With access to vaccines and lockdowns ending, Stewart says that feelings of uncertainty will occur and obsessive compulsive behaviours may return.

There is also concern, Stewart says, that OCD cases will increase after the pandemic is over, as the result of habitual washing practices and increased anxiety and fear towards illness and contamination.

Stewart’s lab has been conducting an ongoing study that has involved over 2,500 respondents and asks participants questions related to OCD tendencies and their implications. The study found that 15 to 17 per cent of respondents reported symptoms related to OCD.

In the general population, OCD typically appears at a rate of between one to two per cent of people.

“I suspect as we return whatever post-COVID life will be, there will be many news cases that will be identified,” says Stewart. “While there may have been some cases that improved during COVID, there may be new onset cases.”