A Study of Phenomenology and Treatment Adherence in Patients with Obsessive-compulsive Disorder during COVID-19 Pandemic

Abstract

Background and Objective: The WHO declared COVID-19 to be a public health emergency which has affected every sphere of life including mental health and is expected to affect the patients of obsessive-compulsive disorder (OCD) adversely. This study aimed to study phenomenology and treatment adherence in patients with the OCD during COVID-19 pandemic. Materials and Methods: The sample consisted of 96 old and new patients of OCD between the age of 18 and 60 years, with the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) ≥16 and onset of illness prior to COVID-19 (March 2020). Diagnosis was made as per ICD-10-DCR, the likelihood of treatment adherence was assessed using the Medication Adherence Rating Scale, and the severity of OCD was assessed on Y-BOCS. The current and past phenomenologies as per D-YBOCS were compared. Among the patients adherent to treatment, subjective response on the current severity of symptoms as compared to before the onset of COVID-19 was recorded. Results: The likelihood of treatment adherence was high (according to the Medication Adherence Scale) in 59.2% of cases. Pandemic reasons were reported by 69% of patients with low likelihood of treatment adherence. Few patients developed new symptoms, but no statistically significant change was found when compared to the pre-COVID-19 phenomenology. Conclusions: Majority of the treatment adherent patients experienced a decrease or no change in their symptom severity as compared to the before COVID-19 severity, suggesting that no worsening of OCD symptoms during the pandemic was observed if the patients were adherent to medications. However, there is a need for long-term considerations and plan interventions accordingly to minimize this deleterious effect.