Impact of the COVID-19 Pandemic on the Short-term Course of Obsessive-Compulsive Disorder

Sharma, L. P.; Balachander, S.; Thamby, A.; Bhattacharya, M.; Kishore, C.; Shanbhag, V.; TS, J.; Narayanaswamy, J. C.; Arumugham, S. S.; Reddy, Y. J.

Background: There is an understandable concern that obsessive-compulsive disorder (OCD) may worsen during the COVID-19 pandemic, but there is little empirical data. We report the impact of COVID-19 pandemic on the short-term course of OCD. We also assessed for predictors of relapse and emergence of COVID-19-themed obsessive-compulsive symptoms. Methods: A cohort of patients with a primary diagnosis of OCD (n=240) who were on regular follow-up at a tertiary care specialty OCD Clinic in India were assessed telephonically, about 2 months after the declaration of the pandemic ('pandemic' cohort). Data from the medical records of an independent set of patients with OCD (n=207) who were followed-up during the same period, one year prior, was used for comparison (historical controls). Results: The 'pandemic' group and historical controls did not differ in the trajectories of the Yale-Brown Obsessive-Compulsive Scale (YBOCS) scores (Chi-square for likelihood-ratio test of the Group x Time interaction = 2.73, p= 0.255) and relapse rate [21% vs 20%, adjusted odds ratio = 0.81 (95% CI 0.41 -1.59, p=0.535]. Pre-existing contamination symptoms and COVID-19-related health anxiety measured by the COVID-Threat Scale did not predict relapse. Only a small proportion of patients (6%) reported COVID-19-themed obsessive-compulsive symptoms. Limitations: Follow-up 2 months after pandemic declaration may be too early understand the true impact. Conclusions: The COVID-19 pandemic, at least in the short-run, did not influence the course of illness in those who were on medications. It would be pertinent to evaluate the long-term impact of the pandemic on the course of OCD.