COVID-19 Pandemic and Mental Health: Prevalence and Correlates of New-Onset Obsessive-Compulsive Symptoms in a Canadian Province (Preprint)

Abstract

Background: The World Health Organization (WHO) declared a global coronavirus disease (COVID-19) pandemic on March 11, 2020. Subsequently, an intensive public health campaign recommending regular hand washing, physical distancing, and facemask use evolved as a global strategy to limit viral transmission.

Objective: This study investigates the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms at an early stage of the COVID-19 pandemic in Canada.

Methods: This a population-based, cross-sectional online survey of Canadians aged 18 years and older. We used the contamination and cleanliness subscale of the Brief Obsessive-Compulsive Scale (BOCS), Perceived Stress Scale (PSS), likely Generalized Anxiety Disorder (GAD) with the Generalized Anxiety Disorder 7-item (GAD-7) scale, and likely Major Depressive Disorder (MDD) with the Patient Health Questionnaire-9 (PHQ-9) scale to investigate prevalence of OCD symptoms and their correlation to perceived stress, anxiety, and depression during the COVID-19 pandemic.

Results: 32,805 individuals who subscribed for supportive text messages with Text4Hope were invited to complete an online survey; 6,041 responded with a mean age of 42 years (age range 11-88 years) and a response rate of 18.4%. Overall, 60.3% of respondents, reported onset of obsessions related to contamination with dirt, germs, or viruses and while 53.8% had compulsions to wash hands during the COVID-19 pandemic. Respondents who were worried about dirt, germs, and viruses only since the start of the COVID-19 pandemic were significantly more likely to have moderate/high stress (z=6.4, p<0.001), likely GAD (z=6.0, p<0.001), and likely MDD (z=2.7, p<0.01) compared to respondents who have never been worried about dirt, germs, and viruses. Similarly, respondents who engage in compulsive hand washing were significantly more likely to have moderate/high stress (z=4.6, p<0.001) and likely GAD (z=4.6 p<0.001) but not likely MDD (z=1.4, p=0.16) compared to respondents who have never engaged in compulsive hand washing.

Conclusion: Prevalence of OCD symptoms increased during the early phase of the COVID-19 pandemic, at a rate significantly higher than pre-pandemic rates reported for the sample population. Presenting with OCD symptoms during the pandemic significantly increases the likelihood for respondents to present with elevated stress levels, likely GAD and likely MDD.