Impact of the COVID-19 Pandemic on Exposure and Response Prevention Outcomes in Adults and Youth with Obsessive-Compulsive Disorder

Highlights

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  This study examines the impact of COVID-19 on ERP outcome.

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  Rates of improvement that would be anticipated outside of a pandemic were attenuated during COVID-19.

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  Patients who endured financial distress or were medically at-risk had worse ERP outcomes.

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  Patients who were children or who had higher baseline doubt/uncertainty fared better in ERP during COVID-19 than adults on average or those with lower levels of doubt/uncertainity.

Abstract

The COVID-19 pandemic has created novel mental health challenges for those with pre-existing problems including obsessive-compulsive disorder (OCD). Our study reports on clinician perceptions regarding the effect of the COVID-19 pandemic on patients with OCD receiving exposure and response prevention treatment (ERP) prior to and during the pandemic. Participating clinicians completed a survey which included questions adapted from National Institute of Mental Health-Global Obsessive-Compulsive Scale (NIMH-GOCS) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinicians rated clinical features at treatment initiation, just prior to the pandemic, and mid-pandemic (July/August, 2020). Findings suggest that the COVID-19 pandemic was associated with attenuation of ERP progress from expected rates in most patients during first several months of the pandemic; clinicians estimated that 38% of their patients had symptoms worsen during the pandemic and 47% estimated that symptoms remained unchanged despite participating in ERP. Those who endured financial distress or were medically at-risk for severe COVID-19 disease had worse ERP course. Adults also had a worse ERP course during than pandemic than youth. Further research is needed to better understand the effect of the COVID-19 pandemic on OCD symptomatology and treatment trajectory post-pandemic.