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Miccoli M, Poli A. Randomized trial on the effects of an EMDR intervention on traumatic and obsessive symptoms during the COVID-19 quarantine: a psychometric study. Front Psychiatry 2024; 15:1369216. [PMID: 38988736 PMCID: PMC11233768 DOI: 10.3389/fpsyt.2024.1369216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/22/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction It has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery. Methods In order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention. Results The EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms. Conclusions EMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined. Clinical trial registration https://www.clinicaltrials.gov, identifier NCT06110702.
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Affiliation(s)
- Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Poli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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2
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Thompson EM, Albertella L, Viskovich S, Pakenham KI, Fontenelle LF. Internet-based acceptance and commitment therapy for obsessive-compulsive symptoms: A randomized controlled trial. Behav Res Ther 2024; 180:104595. [PMID: 38885592 DOI: 10.1016/j.brat.2024.104595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
Subthreshold obsessive-compulsive symptoms (OCS) are associated with increased distress, help seeking behaviours, and functional problems, and may predict progression into further mental health problems. This study investigated the effectiveness of a four-module internet-based acceptance and commitment therapy (iACT) for adults with OCS compared to internet-based progressive relaxation training (iPRT). Eighty-nine adults with OCS participated in a single-blinded randomised controlled trial of iACT or iPRT. Self-report assessments of OCS, psychological flexibility, and quality of life, among others, were measured at baseline, post-treatment, and at three-month follow-up. Both iACT and iPRT showed large pre-post improvements in OCS (b = 6.32, p < 0.001, d = 0.8) and medium improvements in psychological flexibility (b = -0.38, p = 0.011, d = 0.47) and quality of life (b = -5.26, p = 0.008, d = 0.58), with no significant differences in effects between groups. All improvements were maintained at follow-up. There were no differences in attrition or adherence between groups. iACT was rated more favourably by participants at post-treatment, and there were some differences in qualitative feedback across groups. These findings suggest both iPRT and iACT may be helpful in improving mental health in adults with OCS, but that iACT may be more acceptable.
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Affiliation(s)
- Emma M Thompson
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia.
| | - Shelley Viskovich
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
| | - Kenneth I Pakenham
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Leonardo F Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) & D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
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3
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Hühne V, Dos Santos-Ribeiro S, Moreira-de-Oliveira ME, de Menezes GB, Fontenelle LF. Towards the correlates of stressful life events as precipitants of obsessive-compulsive disorder: a systematic review and metanalysis. CNS Spectr 2024:1-9. [PMID: 38685590 DOI: 10.1017/s1092852924000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Obsessive-compulsive disorder (OCD) is a prevalent condition with multifactorial etiology involving genetic and environmental factors. The present study aims to summarize the correlates of stressful life events (SLEs) in OCD by reviewing studies comparing OCD associated or not with SLEs before its onset. To do so, a systematic review was performed by searching PubMed, Web of Science, Scopus, and PsycINFO databases for studies published between the database's inception and November 27, 2023. Studies including individuals whose OCD was precipitated or not by SLEs (SLEs OCD and NSLEs OCD, respectively) were assessed. Effect sizes or odds ratios were then calculated to identify the strength of association between SLEs and clinical characteristics, such as gender, age of onset, family history of OCD, severity of OCD symptoms, depressive symptoms, and mood comorbidities among patients with OCD. Out of the 4083 records initially identified, 5 studies met the inclusion criteria and 3 were comparable through a meta-analysis. Notably, the analyses were limited by the small number of studies available in the literature. The meta-analysis demonstrated SLEs OCD to be associated with female gender, later OCD onset, and increased comorbidity rates with mood disorders. Despite the cross-sectional nature of the reviewed studies, women may be more vulnerable to develop a later onset of OCD following SLEs, which may also lead to mood disorders. Caution is needed to avoid prematurely classifying this presentation as a distinct subtype of OCD.
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Affiliation(s)
- Verônica Hühne
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Samara Dos Santos-Ribeiro
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Maria E Moreira-de-Oliveira
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Gabriela B de Menezes
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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4
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Clarke PJF, Szeremeta E, Van Bockstaele B, Notebaert L, Meeten F, Todd J. Contamination fear and attention bias variability early in the COVID-19 pandemic. Behav Res Ther 2024; 175:104497. [PMID: 38422560 DOI: 10.1016/j.brat.2024.104497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 01/09/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
The onset of the COVID-19 pandemic resulted in a dramatic increase in the salience and importance of information relating to both the risk of infection, and factors that could mitigate against such risk. This is likely to have contributed to elevated contamination fear concerns in the general population. Biased attention for contamination-related information has been proposed as a potential mechanism underlying contamination fear, though evidence regarding the presence of such biased attention has been inconsistent. A possible reason for this is that contamination fear may be characterised by variability in attention bias that has not yet been examined. The current study examined the potential association between attention bias variability for both contamination-related and mitigation-related stimuli, and contamination fear during the early stages of the COVID-19 pandemic. A final sample of 315 participants completed measures of attention bias and contamination fear. The measure of average attention bias for contamination-related stimuli and mitigation-related stimuli was not associated with contamination fear (r = 0.055 and r = 0.051, p > 0.10), though both attention bias variability measures did show a small but statistically significant relationship with contamination fear (r = 0.133, p < 0.05; r = 0.147, p < 0.01). These attention bias variability measures also accounted for significant additional variance in contamination fear above the average attention bias measure (and controlling for response time variability). These findings provide initial evidence for the association between attention bias variability and contamination fear, underscoring a potential target for cognitive bias interventions for clinical contamination fear.
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Affiliation(s)
- Patrick J F Clarke
- Cognition and Emotion Research Group, Faculty of Health Sciences, Curtin University, Australia.
| | - Elise Szeremeta
- Cognition and Emotion Research Group, Faculty of Health Sciences, Curtin University, Australia
| | - Bram Van Bockstaele
- School of Psychological Science, University of Western Australia, Australia; Research Institute of Child Development and Education, University of Amsterdam, the Netherlands
| | - Lies Notebaert
- School of Psychological Science, University of Western Australia, Australia
| | - Frances Meeten
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; School of Psychology, University of Sussex, UK
| | - Jemma Todd
- School of Psychological Science, University of Western Australia, Australia; School of Psychology, University of Sydney, Australia
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Jelinek L, Göritz AS, Miegel F, Schuurmans L, Moritz S, Yassari AH, Müller JC. Too much of a good thing? Hand hygiene and the long-term course of contamination-related obsessive-compulsive symptoms. Front Psychol 2024; 15:1279639. [PMID: 38524298 PMCID: PMC10959097 DOI: 10.3389/fpsyg.2024.1279639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/13/2024] [Indexed: 03/26/2024] Open
Abstract
Increased hygiene behavior may be a factor in the development of contamination-related obsessive-compulsive symptoms (C-OCS). We aimed at investigating (1) the course of C-OCS over 1 year after the start of the COVID-19 pandemic and (2) the effects of changes in hand hygiene (i.e., duration and frequency of handwashing) and related distress regulation on the long-term course of C-OCS. In a longitudinal study, we assessed 1,220 individuals from the German general population at the start of the COVID-19 pandemic (t1), 3 months later (t2), and 12 months later (t3). Pre-pandemic data were available in a subsample from 2014 (n = 430). A decrease in C-OCS over the first year of the pandemic emerged with a small effect size. Thirty-six percent of the participants scored above the clinical cut-off score at t1, 31% at t2, and 27% at t3. In 2014, only 11% scored above the clinical cut-off score. Hierarchical regression showed that C-OCS at t1 was the strongest predictor of a long-term increase in C-OCS. With small effect sizes, change in the duration (not frequency) of handwashing from t1 to t2, as well as the distress-reducing effect of handwashing served as additional predictors. Implications for information on hand hygiene guidelines are discussed.
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Affiliation(s)
- Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja S. Göritz
- Behavioral Health Technology, University Augsburg, Augsburg, Germany
| | - Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lea Schuurmans
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amir H. Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Christina Müller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Sharma LP, Balachander S, Thatikonda NS, Ganesh UM, Kishore C, Bhattacharya M, Thamby A, Ts J, Narayanaswamy JC, Arumugham SS, Reddy YJ. Long-term impact of the COVID-19 pandemic on obsessive-compulsive disorder. Psychiatry Res 2024; 331:115625. [PMID: 38141264 DOI: 10.1016/j.psychres.2023.115625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/18/2023] [Accepted: 11/23/2023] [Indexed: 12/25/2023]
Abstract
There is limited data on the long-term effect of the COVID-19 pandemic on obsessive-compulsive disorder (OCD). We report on the course of a cohort of individuals with OCD followed-up over a period of one year during the first wave of the COVID-19 pandemic in India. A cohort of 240 individuals registered at a specialty OCD clinic was regularly followed-up using standardized rating tools at three months, six months, and one year into the onset of the COVID-19 pandemic in India. These were compared with clinical ratings recorded in a comparable historical cohort of 207 individuals with OCD, followed up during a non-pandemic year. The pandemic and non-pandemic (historical control) cohorts did not differ in illness severity and rate of relapse. It was found that COVID-19-related anxiety declined over time. Among those patients who were treatment responders prior to the pandemic, COVID-19-related anxiety and non-adherence to medication predicted a relapse of symptoms. Contrary to our expectations, the rate of relapse and illness trajectory in the pandemic cohort did not differ from the non-pandemic cohort, suggesting that the pandemic did not impact our largely medication-adherent cohort. Adherence to treatment seemed to have a protective effect during the pandemic.
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Affiliation(s)
- Lavanya P Sharma
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India
| | - Srinivas Balachander
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India.
| | - Navya Spurthi Thatikonda
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India
| | - Uma Maheswari Ganesh
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India; Department of Clinical Psychology, NIMHANS, Bengaluru, Karnataka, India
| | - Chethana Kishore
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India
| | - Mahashweta Bhattacharya
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India; Department of Clinical Psychology, NIMHANS, Bengaluru, Karnataka, India
| | - Abel Thamby
- Senior Psychiatry Registrar, The Royal Melbourne Hospital and Northwestern Mental Health, Melbourne, VIC, Australia
| | - Jaisoorya Ts
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India
| | | | - Shyam Sundar Arumugham
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India
| | - Yc Janardhan Reddy
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka 560029, India
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7
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Moreira-de-Oliveira ME, de Menezes GB, Pozza A, Massa L, Albertella L, Prestia D, Olcese M, Fontenelle LF, Marazziti D. A "transatlantic" follow-up study of the impact of the COVID-19 pandemic on patients with obsessive-compulsive disorder. J Affect Disord 2023; 341:313-318. [PMID: 37661060 DOI: 10.1016/j.jad.2023.08.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Obsessive-compulsive symptom fluctuations may be contingent on the number of stressful pandemic-related events and the resilience characterizing different cultures. We investigated the influence of the pandemic on symptom changes in a sample of obsessive-compulsive disorder (OCD) patients from Brazil and Italy, two countries that were highly affected by the outbreak. METHODS Ninety-one OCD outpatients were evaluated at baseline and about one year later. Thirty of them were assessed in Brazil and 61 in Italy. Socio-demographic variables, symptoms' severity and the number of stressful pandemic-related events were collected. Comparisons between countries' samples were performed, and a linear regression examined whether the country of origin, demographic features and the number of stressful events were able to predict the symptoms' severity at the follow-up. RESULTS Brazilian patients experienced more stressful pandemic-related events than Italian patients (p = 0.018). However, along with higher age (p < 0.01) and increased severity of symptoms at baseline (p < 0.01), lower number of events predicted increased symptoms' severity after one year (p < 0.01). Country of origin was not a significant predictor of severity. LIMITATIONS Small number of subjects; lack of information regarding duration of illness; and potential sample differences between countries. CONCLUSIONS During the pandemic, the occurrence of more stressful pandemic-related events was associated with decreased severity of patients' OCD symptoms. Nevertheless, older patients and those with more severe symptoms seemed prone to exhibit increased OCD severity at follow-up.
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Affiliation(s)
- Maria Eduarda Moreira-de-Oliveira
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Gabriela B de Menezes
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Australia
| | | | - Martina Olcese
- Department of Education Sciences, University of Genoa, Genoa, Italy
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy; Saint Camillus-Unicamillus International University of Medical Sciences, Rome, Italy
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8
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Liu C, Albertella L, Lochner C, Tiego J, Grant JE, Ioannidis K, Yücel M, Hellyer PJ, Hampshire A, Chamberlain SR. Conceptualising compulsivity through network analysis: A two-sample study. Compr Psychiatry 2023; 127:152429. [PMID: 37832377 DOI: 10.1016/j.comppsych.2023.152429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Compulsivity is a transdiagnostic construct crucial to understanding multiple psychiatric conditions and problematic repetitive behaviours. Despite being identified as a clinical- and research-relevant construct, there are limited insights into the internal conceptual structure of compulsivity. To provide a more nuanced understanding of compulsivity, the current study estimated the structure of compulsivity (indexed using the previously validated Cambridge-Chicago Compulsivity Trait Scale, CHI-T) among two large-scale and geographically distinct samples using the network estimation method. The samples consisted of a United Kingdom cohort (n = 122,346, 51.4% female, Mean age = 43.7, SD = 16.5, range = 9-86 years) and a South Africa cohort (n = 2674, 65.6% female, Mean age = 24.6, SD = 8.6, range = 18-65 years). Network community analysis demonstrated that compulsivity was constituted of three interrelated dimensions, namely: perfectionism, cognitive rigidity and reward drive. Further, 'Completion leads to soothing' and 'Difficulty moving from task to task' were identified as core (central nodes) to compulsivity. The dimensional structure and central nodes of compulsivity networks were consistent across the two samples. These findings facilitate the conceptualisation and measurement of compulsivity and may contribute to the early detection and treatment of compulsivity-related disorders.
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Affiliation(s)
- Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Western Cape, South Africa
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Jon E Grant
- Department of Psychiatry & Behavioural Neuroscience, University of Chicago, Chicago, USA
| | - Konstantinos Ioannidis
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Peter J Hellyer
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
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9
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Jalalifar E, Arad A, Rastkar M, Beheshti R. The COVID-19 pandemic and obsessive-compulsive disorder: a systematic review of comparisons between males and females. Acta Neuropsychiatr 2023; 35:270-291. [PMID: 36861432 DOI: 10.1017/neu.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Coronavirus disease, one of the most disastrous epidemics, has caused a worldwide crisis, and the containment measures applied to decelerate the progression of the pandemic can increase the risk of obsessive-compulsive disorder (OCD). Identifying vulnerable groups in this area can lead us to better resource expenditure, and therefore, this systematic review aims to make a comparison between males and females to determine which of the two groups was most affected by the COVID-19 pandemic regarding OCD. Also, a meta-analysis was designed to investigate the prevalence of OCD during the COVID-19 pandemic. A comprehensive search was conducted among three databases (Medline, Scopus, Web of Science) until August 2021 which resulted in 197 articles, and 24 articles met our inclusion criteria. Overall, more than half of the articles stated the role of gender in OCD during the COVID-19 pandemic. Several articles emphasized the role of the female gender, and some others the role of the male gender. The meta-analysis revealed a 41.2% overall prevalence of OCD during the COVID pandemic and 47.1% and 39.1% OCD prevalence for female and male genders respectively. However, the difference between the two genders was not statistically significant. Generally, it seems that females are at greater risk of OCD during the COVID-19 pandemic. In the following groups, the female gender may have acted as a risk factor: under-18 years students, hospital staff, and the studies in the Middle East. In none of the categories, male gender was clearly identified as a risk factor.
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Affiliation(s)
- Erfan Jalalifar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirreza Arad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Rastkar
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasa Beheshti
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
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10
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Brierley MEE, Albertella L, Christensen E, Rotaru K, Jacka FN, Segrave RA, Richardson KE, Lee RS, Kayayan E, Hughes S, Yücel M, Fontenelle LF. Lifestyle risk factors for obsessive-compulsive symptoms and related phenomena: What should lifestyle interventions target? Aust N Z J Psychiatry 2023; 57:379-390. [PMID: 35362326 DOI: 10.1177/00048674221085923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Understanding the impact of lifestyle on mental illness symptoms is important for informing psycho-education and developing interventions which target mental and physical comorbidities. Obsessive-compulsive and related disorders can have a significant impact on health-related quality of life and physical health. However, our understanding of the impact of lifestyle on obsessive-compulsive symptoms and broader compulsive and impulsive problematic repetitive behaviours is limited. AIMS We investigated whether lifestyle factors predicted change in obsessive-compulsive symptoms and problematic repetitive behaviours in a general population sample over a 3-month period. METHODS Eight hundred thirty-five participants completed an online questionnaire battery assessing lifestyle and mental health. Of these, 538 participants completed the same battery 3 months later. We conducted negative binomial regressions to analyse the association of lifestyle factors at baseline with future (1) obsessive-compulsive symptoms, (2) compulsive problematic repetitive behaviours and (3) impulsive problematic repetitive behaviours, adjusting for baseline obsessive-compulsive symptoms and problematic repetitive behaviours. RESULTS Lower vegetable (p = 0.020) and oily fish (p = 0.040) intake and lower moderate intensity physical activity (p = 0.008) predicted higher obsessive-compulsive symptoms at follow-up. Higher intake of high-fat foods (p < 0.001) predicted higher compulsive problematic repetitive behaviours at follow-up. No lifestyle factors significantly predicted impulsive problematic repetitive behaviours at follow-up. CONCLUSION Our results speak to the potential importance of lifestyle quality screening, education and lifestyle interventions (e.g. an anti-inflammatory diet) for individuals experiencing compulsivity-related behaviours and/or symptoms. Further research into potential mechanisms of action will allow for more targeted approaches to lifestyle interventions for transdiagnostic compulsive behaviours.
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Affiliation(s)
- Mary-Ellen E Brierley
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Kristian Rotaru
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia.,Monash Business School, Monash University, Caulfield, VIC, Australia
| | - Felice N Jacka
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Rebecca A Segrave
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Karyn E Richardson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Rico Sc Lee
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Edouard Kayayan
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Sam Hughes
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Leonardo F Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia.,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,D'Or Institute for Research and Education, Rio de Janeiro, Brazil
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11
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Şengül Avşar A, Avşar V. Development of the COVID-19-Specific Obsessive Compulsive Symptoms Scale with Various Validity and Reliability Proofs. Int J Cogn Ther 2022; 16:58-80. [PMID: 36531984 PMCID: PMC9744046 DOI: 10.1007/s41811-022-00155-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
The COVID-19 epidemic, which spread rapidly around the world, has had a significant negative impact on mental health. Obsessive-compulsive disorder (OCD) issues are among the main mental health effects of COVID-19. The purpose of this study is to develop a brief measurement tool that reliably and validly measures obsessive-compulsive (OC) symptoms in people with COVID-19. A total of 483 people took part in the research online. Individuals with aberrant item scores were excluded, and a series of validity and reliability analyses were performed to determine the psychometric properties of the COVID-19-specific obsessive compulsive symptoms scale (C19-OCS). C19-OCS was found to be a valid and reliable measure for assessing OC symptoms in relation to COVID-19. Mental health professionals could use C19-OCS to develop evidence-based intervention strategies and programs.
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Affiliation(s)
- Asiye Şengül Avşar
- Department of Measurement and Evaluation in Education, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Volkan Avşar
- Department of Psychological Counselling and Guidance, Recep Tayyip Erdoğan University, Rize, Turkey
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12
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Tuygar Okutucu F, Ceyhun HA. Obsessive-Compulsive Disorder During the COVID-19 Pandemic Process: A Narrative Review. Eurasian J Med 2022; 54:77-90. [PMID: 36655450 PMCID: PMC11163355 DOI: 10.5152/eurasianjmed.2022.22221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/30/2022] [Indexed: 01/19/2023] Open
Abstract
This study aimed to review all empirical contributions published between March 2020 and June 2022, addressing the impact of the COVID-19 pandemic on obsessive-compulsive disorder in adults. We searched the literature in PubMed, Google Scholar, and Web of Science. A total of 543 articles were scanned and 73 full-text articles were identified. Reviews, comments, letters to the editor, and case reports (except case series) were excluded. It was determined that 42 articles met the inclusion criteria, 6 studies involving only children and adolescents were excluded, and 36 were decided on their suitability for our study. The analysis determined that COVID-19 had an impact on obsessive-compulsive disorder. Characteristics such as liability for harm and unacceptable thoughts influenced the symptoms as well as contamination and washing. Some studies showed an increase in the severity of obsessive-compulsive symptoms, while some reported no worsening but improvement with treatment and follow-up. While some reported variations in outcomes related to sociodemographic characteristics and subtypes, some focused on the risk of suicide. There were also studies conducted on special groups such as pregnant women or healthcare workers. The results were controversial. While available data contain more information on worsening obsessive-compulsive disorder symptoms, data on the status of patients under treatment were scarce. There were not enough studies evaluating follow-up results. Influencing factors such as sociodemographic characteristics, subtypes, comorbid conditions, treatment, and support did not seem to have been adequately addressed.
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Affiliation(s)
- Fatma Tuygar Okutucu
- Department of Psychiatry, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Hacer Akgul Ceyhun
- Department of Psychiatry, Atatürk University Faculty of Medicine, Erzurum, Turkey
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13
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Quinn A, Grant JE, Chamberlain SR. COVID-19 and resultant restrictions on gambling behaviour. Neurosci Biobehav Rev 2022; 143:104932. [PMID: 36341942 PMCID: PMC9617674 DOI: 10.1016/j.neubiorev.2022.104932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Since the onset of COVID-19, studies suggest a significant increase in online gambling, potentially facilitated by increased time at home, social isolation and boredom. This study aimed to address what is known about the impact of the pandemic on gambling behaviour by conducting a mapping review. A systematic literature search was conducted using four online databases. Additional studies were identified using reference lists. Relevant studies were quality scored and their findings synthesised in terms of overall changes at the population level and potentially vulnerable groups. The weight of evidence from 35 relevant reports across 12 countries indicated reductions of gambling during the pandemic at the level of the general population. However, marked increases in gambling amongst vulnerable sub-populations including amongst young adults and people with pre-existing at-risk gambling were also noted. The impact of COVID-19 on gambling is highly contingent on context. If policy makers examine only population level data, this could overlook profound negative effects identified in those with at-risk gambling, gambling disorder, and amongst young adults.
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Affiliation(s)
- Anthony Quinn
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK,Correspondence to: Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton, Hampshire, SO14 3DT, UK
| | - Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, USA
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK
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14
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Grøtte T, Hagen K, Eid J, Kvale G, le Hellard S, Solem S. Changes in contamination-related obsessions and compulsions during the COVID-19 pandemic: A Norwegian longitudinal study. J Obsessive Compuls Relat Disord 2022; 35:100758. [PMID: 36276590 PMCID: PMC9578966 DOI: 10.1016/j.jocrd.2022.100758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Early stages of the COVID-19 pandemic have been associated with increasing obsessive-compulsive symptoms (OCS), but less is known regarding these symptoms' long-term trajectories. The aim of this study was to examine changes in contamination-related OCS in the Norwegian public during early and late stages of the pandemic, as well as characteristics that might be associated with these changes. METHODS In a longitudinal online survey, 12 580 participants completed self-report questionnaires in April 2020, including a retrospective assessment of contamination-related OCS severity (DOCS-SF) prior to COVID-19. In December 2020, 3405 (27.1%) of the participants completed the survey again. RESULTS In April, participants retrospectively recalled that their contamination-related OCS were lower prior to COVID-19 (d = 1.09). From April to December, symptoms slightly decreased (d = -0.16). The proportion of participants scoring above the clinical cut-off on DOCS-SF (≥16) changed accordingly from 2.4% pre-COVID to 27.8% in April and 24.0% in December. Previous severity of contamination-related OCS and symptoms of distress related to COVID-19 were the most powerful predictors of contamination-related OCS severity during the pandemic. CONCLUSIONS Elevated levels of contamination-related OCS were detected at both early and late stages of the pandemic, but the long-term symptom trend seems to be slightly declining.
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Affiliation(s)
- Torun Grøtte
- Department of Psychology, Norwegian University of Science and Technology, Norway
| | - Kristen Hagen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
- Molde Hospital, Møre og Romsdal Hospital Trust, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Norway
| | - Jarle Eid
- Department of Psychology, Norwegian University of Science and Technology, Norway
- Center for Crisis Psychology, University of Bergen, Norway
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
- Department of Clinical Psychology, University of Bergen, Norway
| | - Stephanie le Hellard
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Norway
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15
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Zhao Y, Yu Y, Zhao R, Cai Y, Gao S, Liu Y, Wang S, Zhang H, Chen H, Li Y, Shi H. Association between fear of COVID-19 and hoarding behavior during the outbreak of the COVID-19 pandemic: The mediating role of mental health status. Front Psychol 2022; 13:996486. [PMID: 36211904 PMCID: PMC9534310 DOI: 10.3389/fpsyg.2022.996486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Hoarding behavior can effectively improve people's ability to resist risks, so as to reduce the negative effects of risks. However, excessive hoarding behavior will seriously reduce people's quality of life. The COVID-19 pandemic can cause excessive hoarding in a large number of people in a short period of time, and also cause a series of economic problems such as social material shortage. It is unclear how hoarding levels are linked to fear and negative emotions caused by COVID-19 among people of different educational backgrounds and social status. The purpose of this study was to explore the relationship between fear of COVID-19 and hoarding behavior in different populations in school and social contexts, as well as the mediating role of negative emotions and the moderating role of subjective/objective social status and education level in this process. An online cross-sectional survey was conducted in various provinces in China in January 2022. Demographic information, the MacArthur Scale of Subjective Social Status, the Fear of COVID-19 scale, the Depression Anxiety Stress-21, and the Saving Inventory-Revised were used to evaluate the severity of individual hoarding symptoms, the frequency of hoarding, the degree of fear, and the negative emotions (depression, anxiety, stress) caused by COVID-19. Research data showed that fear of COVID-19 was significantly correlated with hoarding behavior (p < 0.05). Fear of COVID-19 was significantly lower in the student sample than in the nonstudent sample (p < 0.05). Negative emotions played a mediating role in the relationship between fear of COVID-19 and hoarding behavior (p < 0.05). Educational and economic levels moderated this process, but social status did not. Compared with the student sample, educational background and income had less of a moderating effect on the depression, anxiety, and stress caused by fear of COVID-19 in the nonstudent sample. However, these factors had a more regulative effect on the clutter and excessive acquisition behavior caused by depression, anxiety, and stress, although not on difficulty discarding. These findings suggest that reduce negative emotions in the population, improve cognitive levels, and provide financial support from governments may be effective ways to reduce hoarding symptoms.
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Affiliation(s)
- Ye Zhao
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Yang Yu
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Ruofan Zhao
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Yiming Cai
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Shuai Gao
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Ye Liu
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Sheng Wang
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
| | - Huifeng Zhang
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Early Life Health Research Center, Hebei Medical University, Shijiazhuang, China
| | - Haiying Chen
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Nursing School, Hebei Medical University, Shijiazhuang, China
- *Correspondence: Haiying Chen,
| | - Youdong Li
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Early Life Health Research Center, Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Youdong Li,
| | - Haishui Shi
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang, China
- Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang, China
- Early Life Health Research Center, Hebei Medical University, Shijiazhuang, China
- Department of Biochemistry and Molecular Biology, College of Basic Medicine, Hebei Medicinal University, Shijiazhuang, China
- Haishui Shi,
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16
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Pacitti F, Socci V, D'Aurizio G, Jannini TB, Rossi A, Siracusano A, Rossi R, Di Lorenzo G. Obsessive-compulsive symptoms among the general population during the first COVID-19 epidemic wave in Italy. J Psychiatr Res 2022; 153:18-24. [PMID: 35792342 PMCID: PMC9239523 DOI: 10.1016/j.jpsychires.2022.06.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023]
Abstract
This study investigated obsessive-compulsive symptoms (OCS) in the Italian general population during the initial stage of the pandemic and the impact of COVID-19 related potential risk factors. A web-based survey was spread throughout the internet between March 27th and April 9th, 2020. Twenty thousand two hundred forty-one individuals completed the questionnaire, 80.6% women. The Dimensional Obsessive-Compulsive Scale (DOCS) was included to assess the severity of the obsessive-compulsive symptom domains. Further, selected outcomes were depression, anxiety, insomnia, perceived stress, and COVID-19 related stressful life events. A panel of logistic or linear regression analyses was conducted to explore the impact of COVID-19 related risk factors, socio-demographic variables, and mental health outcomes on OCS. A total of 7879 subjects (38,9%) reported clinically relevant OCS. Specifically, more than half of the sample (52%) reported clinically relevant symptoms in the Contamination domain, 32.5% in the Responsibility domain, 29.9% in the Unacceptable thoughts domain, and 28.6 in the Symmetry/Ordering domain. Being a woman was associated with OCS, except for Symmetry/Ordering symptoms. A lower education level and younger age were associated with OCS. Moreover, depression, anxiety, perceived stress symptoms, insomnia, and different COVID-19 related stressful events were associated with OCS. We found high rates of OCS, particularly in the contamination domain, in the Italian general population exposed to the first COVID-19 epidemic wave and COVID-19 related risk factors. These findings suggest the need to investigate further the trajectories of OCS in the general population along with the long-term socio-economic impact of the pandemic.
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Affiliation(s)
- Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | | | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | | | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Italy.
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17
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Goldstein Ferber S, Shoval G, Zalsman G, Weller A. Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications. World J Psychiatry 2022; 12:1004-1015. [PMID: 36158308 PMCID: PMC9476837 DOI: 10.5498/wjp.v12.i8.1004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/28/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
The clinical presentation that emerges from the extensive coronavirus disease 2019 (COVID-19) mental health literature suggests high correlations among many conventional psychiatric diagnoses. Arguments against the use of multiple comorbidities for a single patient have been published long before the pandemic. Concurrently, diagnostic recommendations for use of transdiagnostic considerations for improved treatment have been also published in recent years. In this review, we pose the question of whether a transdiagnostic mental health disease, including psychiatric and neuropsychiatric symptomology, has emerged since the onset of the pandemic. There are many attempts to identify a syndrome related to the pandemic, but none of the validated scales is able to capture the entire psychiatric and neuropsychiatric clinical presentation in infected and non-infected individuals. These scales also only marginally touch the issue of etiology and prevalence. We suggest a working hypothesis termed Complex Stress Reaction Syndrome (CSRS) representing a global psychiatric reaction to the pandemic situation in the general population (Type A) and a neuropsychiatric reaction in infected individuals (Type B) which relates to neurocognitive and psychiatric features which are part (excluding systemic and metabolic dysfunctions) of the syndrome termed in the literature as long COVID. We base our propositions on multidisciplinary scientific data regarding mental health during the global pandemic situation and the effects of viral infection reviewed from Google Scholar and PubMed between February 1, 2022 and March 10, 2022. Search in-clusion criteria were "mental health", "COVID-19" and "Long COVID", English language and human studies only. We suggest that this more comprehensive way of understanding COVID-19 complex mental health reactions may promote better prevention and treatment and serve to guide implementation of recommended administrative regulations that were recently published by the World Psychiatric Association. This review may serve as a call for an international investigation of our working hypothesis.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
| | - Gal Shoval
- Department of Psychiatry, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Neuroscience, Princeton University, Princeton, NJ 08544, United States
| | - Gil Zalsman
- Department of Psychiatry, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Psychiatry, Columbia University, New York, NY 10032, United States
| | - Aron Weller
- Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
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18
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Parental surveillance of OCD and mental health symptoms during COVID-19: A longitudinal study of Australian children, adolescents and families. J Psychiatr Res 2022; 152:225-232. [PMID: 35753242 PMCID: PMC9179103 DOI: 10.1016/j.jpsychires.2022.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/08/2022] [Accepted: 06/06/2022] [Indexed: 11/21/2022]
Abstract
To ensure the needs of children and families are met for the remainder of the COVID-19 situation and beyond there is a demand for a specific response strategy. This longitudinal study will investigate the impact of COVID-19 on Australian parental and childhood mental health symptoms, particularly OCD symptoms, examining the stability of this relationship over time and the needs and preferences for mental health support in response to child symptoms. A total of 141 parents completed a questionnaire during the lockdown period in Australia (June-September 2020). Thirty-five of them completed a follow-up questionnaire during the post-lockdown period (November 2020-January 2021). The questionnaire assessed COVID-19 experiences/worries/knowledge, child OCD, and child/parental anxiety and depression. Sub-samples of youth were determined based on parent-report of an existing diagnosis of any mental health (n = 24), of OCD (n = 22), or no mental health diagnosis (i.e., healthy, n = 81). Results: Parents reported a significant positive association between increased parental worries regarding COVID-19, and their own as well as their child's mental health symptoms. The current sample of children experienced elevated symptom severity for OCD symptoms during COVID-19. The OCD group reported significant reductions in child OCD symptoms at post-lockdown. The any mental health diagnosed children are at greater risk of developing OCD symptoms and reported strong preferences for increased support as a result. The exploratory nature of this study adds further insight into the impact of the COVID-19 pandemic on child OCD and parent mental health symptoms and the stability of symptoms over time.
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19
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Demaria F, Pontillo M, Di Vincenzo C, Di Luzio M, Vicari S. Hand Washing: When Ritual Behavior Protects! Obsessive-Compulsive Symptoms in Young People during the COVID-19 Pandemic: A Narrative Review. J Clin Med 2022; 11:jcm11113191. [PMID: 35683574 PMCID: PMC9181440 DOI: 10.3390/jcm11113191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive–compulsive (OC) symptoms in this population. OC symptoms are widespread in the general population, with varying degrees of intensity. At their most extreme, they manifest in obsessive–compulsive disorder (OCD), which is characterized by obsessive thoughts and compulsive behaviors. The present narrative review aimed at evaluating the relationship between the COVID-19 pandemic and OCD and OC symptoms in young people, especially children and adolescents with and without OCD, focusing on vulnerability and risk factors and the impact of lockdown measures. Of the six studies identified, four examined clinical samples diagnosed with OCD and two looked at community-based adolescent samples. Five of the six studies found that OC symptoms increased during the pandemic. Additionally, vulnerability to anxiety may constitute a risk condition and the lockdown measures and personal stressful life events can constitute potential triggers of OC symptoms, while ongoing treatment for OCD had a protective effect. The results suggest that, during the COVID-19 pandemic, obsessive and compulsive behavior (e.g., hand washing) in young people at the greatest risk should be monitored, and the intervention of mental health services should be maintained. More research is needed in this area.
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Affiliation(s)
- Francesco Demaria
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
- Correspondence: ; Tel.: +39-06-6859-2735; Fax: +39-06-6859-2450
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
| | - Cristina Di Vincenzo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
| | - Michelangelo Di Luzio
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.P.); (C.D.V.); (M.D.L.); (S.V.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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20
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Laurito LD, Loureiro CP, Faro L, Dias RV, Torres B, Moreira-de-Oliveira ME, Santos-Ribeiro SD, de Menezes GB, Fontenelle LF, Davis CH, Twohig MP. Acceptance and Commitment Therapy for obsessive compulsive disorder in a Brazilian context: Treatment of three cases. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Berman NC, Fang A, Hoeppner SS, Reese H, Siev J, Timpano KR, Wheaton MG. COVID-19 and obsessive-compulsive symptoms in a large multi-site college sample. J Obsessive Compuls Relat Disord 2022; 33:100727. [PMID: 35529829 PMCID: PMC9059345 DOI: 10.1016/j.jocrd.2022.100727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic poses unique risks to college students' mental health, and specifically to symptoms of obsessive-compulsive disorder (OCD). To better understand the relationship between COVID-19 impact and OC symptoms in this population, six colleges from across the US administered a battery of questionnaires and an emotion differentiation paradigm to eligible students (N = 841). We examined whether degree of pandemic-related disruption was associated with OC severity, and if so, whether this relationship was explained by trait (poor emotion regulation and differentiation) and state risk factors (poor sleep quality, less exercise frequency, less social support, thwarted sense of belongingness, and greater loneliness). Results indicated that the positive relationship between COVID-19 impact and OC severity was mediated by trait emotion-related processes (e.g., emotion regulation and differentiation), but no state risk factors emerged as significant mediators. Our findings contribute to the literature demonstrating a significant relationship between COVID-19 impact and OC severity, and highlight that emotion regulation difficulties may help explain this association. Our findings can inform evidence-based interventions on college campuses; however, the cross-sectional design precludes causal inferences. Future research should evaluate these relationships longitudinally and incorporate other psychosocial factors that may operate as mechanisms.
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Affiliation(s)
| | - Angela Fang
- University of Washington, Department of Psychology, USA
| | - Susanne S Hoeppner
- Massachusetts General Hospital, Department of Psychiatry, OCD and Related Disorders, USA
| | | | | | | | - Michael G Wheaton
- Barnard College of Columbia University, Department of Psychology, USA
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22
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Moreira-de-Oliveira ME, de Menezes GB, Loureiro CP, Laurito LD, Albertella L, Fontenelle LF. The impact of COVID-19 on patients with OCD: A one-year follow-up study. J Psychiatr Res 2022; 147:307-312. [PMID: 35123340 PMCID: PMC8803396 DOI: 10.1016/j.jpsychires.2022.01.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/13/2022] [Accepted: 01/28/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Since the onset of the COVID-19 pandemic, concerns regarding its psychological effects on people with preexisting psychiatric disorders have been raised, particularly obsessive-compulsive disorder (OCD). Nevertheless, only a few longitudinal studies have been performed, and a more longstanding follow-up of a clinical sample is needed. In this study, our aim was to investigate the influence of the COVID-19 pandemic on symptom changes in a sample of Brazilian OCD patients for about a one-year period. METHODS Thirty OCD outpatients seen in a specialized OCD clinic in Rio de Janeiro were evaluated at baseline and after one year (during the pandemic). Sociodemographic and clinical variables were collected along with a questionnaire aimed at quantifying the number of stressful events related to the COVID-19 pandemic. Comparisons between two time points (pre vs. during COVID-19) and two subgroups (patients with vs without worsening of symptoms) were carried out. RESULTS As a group, OCD patients treated with SRIs had an overall stabilization of symptoms throughout the follow-up period, regardless of the number of stressful experiences related to coronavirus (median baseline YBOCS remained 22.0 at follow-up). In addition, when individually analyzed, even those who reported an increase in their symptoms did not describe a greater number of COVID-19 related events. CONCLUSIONS Patients with OCD, who were under treatment, did not show significant symptom deterioration as a result of the COVID-19 pandemic. Individual variations in OCD symptom severity did not seem to be related to experiences linked to coronavirus.
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Affiliation(s)
- Maria E. Moreira-de-Oliveira
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil,Corresponding author. Rua Diniz Cordeiro, 30, Botafogo, Rio de Janeiro, 22281-100, Brazil
| | - Gabriela B. de Menezes
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carla P. Loureiro
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luana D. Laurito
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucy Albertella
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia.
| | - Leonardo F. Fontenelle
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
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23
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Jelinek L, Röhrig G, Moritz S, Göritz AS, Voderholzer U, Riesel A, Yassari AH, Miegel F. Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:816-835. [PMID: 35174521 PMCID: PMC9111568 DOI: 10.1111/bjc.12362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/25/2022] [Indexed: 12/23/2022]
Abstract
Objective Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive‐compulsive disorder/symptoms (OCD/OCS). During the COVID‐19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS. Method In Study 1, we investigated UP in the general population (N = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS‐CoV‐2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/−) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (N = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS‐CoV‐2 at the start of the pandemic and re‐assessed OCS 3 months later. Results In Study 1, UP was higher in the OCS+ compared to the OCS− group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS‐CoV‐2, but not for infection itself. Conclusions Exaggeration of one’s personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample. Practitioner points Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well‐being in the face of danger or uncertainty. The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive‐compulsive disorder and may also be involved in the development of the disorder. This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.
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Affiliation(s)
- Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Gloria Röhrig
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Anja S Göritz
- Occupational and Consumer Psychology, University of Freiburg, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Germany
| | - Anja Riesel
- Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany
| | - Amir H Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
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24
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Katz TC, Bui TH, Worhach J, Bogut G, Tomczak KK. Tourettic OCD: Current understanding and treatment challenges of a unique endophenotype. Front Psychiatry 2022; 13:929526. [PMID: 35966462 PMCID: PMC9363583 DOI: 10.3389/fpsyt.2022.929526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Obsessive compulsive disorder (OCD) and chronic tic disorders (CTD) including Tourette Syndrome (TS) are often comorbid conditions. While some patients present with distinct symptoms of CTD and/or OCD, a subset of patients demonstrate a unique overlap of symptoms, known as Tourettic OCD (TOCD), in which tics, compulsions, and their preceding premonitory urges are overlapping and tightly intertwined. The specific behaviors seen in TOCD are typically complex tic-like behaviors although with a compulsive and partially anxious nature reminiscent of OCD. TOCD is not classified within the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as an independent diagnostic entity, but mounting evidence suggests that TOCD is an intermediate neuropsychiatric disorder distinct from either TS or OCD alone and as such represents a unique phenomenology. In this review of TOCD we discuss clinical, genetic, environmental, neurodevelopmental, and neurocircuit-based research to better characterize our current understanding of this disorder. TOCD is characterized by earlier age of onset, male predominance, and specific symptom clusters such as lower tendency toward compulsions related to checking, cleaning, and reassurance seeking and higher tendency toward compulsions such as rubbing, tapping, or touching associated with symmetry concerns or thoughts of exactness. Functional magnetic resonance imaging (fMRI) imaging suggests that TOCD symptoms may arise from involvement of an intermediate neurocircuitry distinct from classic OCD or classic CTD. Small cumulative contributions from multiple genetic loci have been implicated, as have environmental factors such as infection and perinatal trauma. In addition, this review addresses the treatment of TOCD which is especially complex and often treatment resistant and requires pharmacology and behavioral therapy in multiple modalities. Given the distressing impact of TOCD on patients' functioning, the goal of this review is to raise awareness of this distinct entity toward the goal of improving standards of care.
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Affiliation(s)
- Tamar C Katz
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - Thanh Hoa Bui
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Jennifer Worhach
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Gabrielle Bogut
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Kinga K Tomczak
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
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25
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Zhao G, Li S, Zhang Q, Guo X, Xie F, Yan S, Liu H, Chong Y, Ding Y, Li X. The relationship between schizotypal personality features and mind wandering among college students during COVID-19 pandemic: A moderator of depression. Front Psychiatry 2022; 13:994082. [PMID: 36713899 PMCID: PMC9874124 DOI: 10.3389/fpsyt.2022.994082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Although the impact of the COVID-19 pandemic on people's mental health has been well documented in many studies, the schizotypal personality features in the general population have not received sufficient attention. METHODS Study 1 is a longitudinal study tracking changes in schizotypal personality features among college students during the COVID-19 pandemic. A total of 153 Chinese college students were assessed using the Schizotypal Personality Questionnaire. Study 2 explored the relationship between schizotypal personality features, mind wandering, and depression. A total of 557 college students completed the Schizotypal Personality Questionnaire, the Beck Depression Inventory, and the Mind-Wandering Questionnaire during the COVID-19 pandemic. RESULTS Study 1 results showed that the scores from later stages in the pandemic were significantly higher than those from the initial stages on each dimension of schizotypal personality, which means that the schizotypal personality features became more obvious during the COVID-19 pandemic. Study 2 results showed that there was a positive correlation between schizotypal personality features, depression, and mind wandering. DISCUSSION Depression played a moderating role in the relationship between schizotypal personality features and mind wandering. The schizotypal personality features of college students increase during COVID-19; it has a positive relationship with mind wandering; depression moderates the relationship. We discussed these findings and provided some suggestions about future research.
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Affiliation(s)
- Guojun Zhao
- School of Psychology, Northwest Normal University, Lanzhou, China.,Academy of Plateau Science and Sustainability, Qinghai Normal University, Xining, China
| | - Shuangchen Li
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Qi Zhang
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Xiaoxiao Guo
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Fusen Xie
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Shuhong Yan
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Haijian Liu
- School of Education, Northwest Normal University, Lanzhou, China
| | - Yuan Chong
- School of Tourism, Northwest Normal University, Lanzhou, China
| | - Yuee Ding
- Mental Health Education Center, Gansu Health Vocational College, Lanzhou, China
| | - Xu Li
- Mental Health Education Center, Gansu Health Vocational College, Lanzhou, China
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26
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Grant JE, Drummond L, Nicholson TR, Fagan H, Baldwin DS, Fineberg NA, Chamberlain SR. Obsessive-compulsive symptoms and the Covid-19 pandemic: A rapid scoping review. Neurosci Biobehav Rev 2022; 132:1086-1098. [PMID: 34740755 PMCID: PMC8570941 DOI: 10.1016/j.neubiorev.2021.10.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been much speculation about untoward effects of the Covid-19 pandemic on psychological symptoms. OCD may be expected to be especially impacted. Our aim was to distil the current evidence base on relationships between the pandemic and obsessive-compulsive symptoms, in patients, and general population samples. METHODS We conducted a rapid scoping review, in the form of a systematic literature search, coupled with narrative review. 32 relevant papers were identified. RESULTS AND INTERPRETATION (1) A sizable proportion of people with OCD (but not all) experienced/reported symptom worsening during the pandemic, especially during initial restrictions (approximately 20-65 % of cases in longitudinal studies); (2) contamination/washing symptoms appeared particularly susceptible; and (3) OCD symptoms in general population samples were associated with trait compulsivity and pandemic-related-stress. The literature was heterogeneous with various methodological issues being commonplace. FUTURE DIRECTIONS The review identified important unaddressed issues: how should exposure based therapy be adapted during pandemics? How can we minimise harm from exacerbation of OCD in vulnerable individuals arising from public health messaging? Why do some but not all OCD patients experience worsening? And does Covid-19 infection affect (or lead to) OCD symptoms?
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Affiliation(s)
- Jon E. Grant
- Department of Psychiatry, University of Chicago, Chicago, USA
| | - Lynne Drummond
- South West London and St George’s NHS Trust and University of Hertfordshire, UK
| | - Timothy R. Nicholson
- Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Harry Fagan
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK
| | - David S. Baldwin
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK
| | - Naomi A. Fineberg
- National Treatment Service for OCD (England and Wales), Hertfordshire, UK
| | - Samuel R. Chamberlain
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK,Corresponding author at: Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK
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27
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Linde ES, Varga TV, Clotworthy A. Obsessive-Compulsive Disorder During the COVID-19 Pandemic-A Systematic Review. Front Psychiatry 2022; 13:806872. [PMID: 35401266 PMCID: PMC8989845 DOI: 10.3389/fpsyt.2022.806872] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and its associated restrictions may contribute to a deterioration in mental health; individuals with obsessive-compulsive disorder (OCD) may be particularly affected. This systematic review aimed to investigate the effects of the current pandemic on people diagnosed with OCD, and whether pandemics may affect the development of OCD symptoms. METHODS We conducted a systematic search using NCBI PubMed, SCOPUS, and Google Scholar on February 9, 2021. Research articles related to OCD and COVID-19 or other pandemics were attempted to be identified using pre-defined search terms. Case reports, clinical guidelines, letters, and clinical research articles including ≥100 participants were included; reviews were excluded. The systematic review adheres to PRISMA guidelines and the Newcastle-Ottawa Scale was used to assess the quality of the included clinical research articles. RESULTS A total of 79 articles were included in the full-text assessment. Of these, 59 were clinical research articles, two were clinical guidelines, six were case reports, and 12 were letters. The research articles examined OCD symptoms in adult patients with diagnosed OCD, the general population, pregnant women, healthcare workers, students, and young adults, children, and adolescents. Only one study on OCD in previous pandemics was identified. CONCLUSION This systematic review found that people both with and without diagnosed OCD prior to the pandemic generally experienced a worsened landscape of symptoms of OCD during the COVID-19 pandemic. However, the responses are heterogeneous and many factors other than the pandemic seemed to affect the development of OCD symptoms. To prevent the impairment of symptoms and the development of new cases, close monitoring of patients with OCD and education of the general public is essential. Literature is still limited; thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.
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Affiliation(s)
- Elisabeth S Linde
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amy Clotworthy
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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28
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Thompson EM, Brierley MEE, Destrée L, Albertella L, Fontenelle LF. Psychological flexibility and inflexibility in obsessive-compulsive symptom dimensions, disability, and quality of life: An online longitudinal study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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29
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TÜRKÇAPAR MH, KAHYA Y, ÇAPAR-TAŞKESEN T, IŞIK H. Managing life during the pandemic: communication strategies, mental health, and the ultimate toll of the COVID-19. Turk J Med Sci 2021; 51:3168-3181. [PMID: 34284533 PMCID: PMC8771019 DOI: 10.3906/sag-2106-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/20/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim The purpose of this review was to present the ultimate toll of the COVID-19 pandemic by focusing on the communication strategies and mental health. Materials and methods We unsystematically reviewed the studies published between 2020 and 2021 from databases such as Google Scholar, Web of Science and ScienceDirect. Firstly, “new-normal” life challenges during the pandemic were discussed along with the public risk communication strategies. Later, mental health problems, posttraumatic growth, and protective factors were reviewed. Results Literature highlighted that individuals mainly experience COVID-19 related fear, anxiety, stress, negative emotions and sleep problems. Furthermore, the rates of clinically significant depression, anxiety, obsessive compulsive disorder, and posttraumatic stress disorder suggest an increase. Specifically, COVID-19 stress syndrome, loneliness, and sleep problems were associated with mental health problems in the pandemic. However, some individuals seem to be resilient to the COVID-19 trauma and experience posttraumatic growth. Brief online intervention studies are promising for reducing the emotional toll of the COVID-19 as well as for making individuals more resilient. Conclusion To conclude, the negative conditions of the pandemic seem to make some people, but not all, vulnerable to mental illness. In addition, framing the public warnings in an optimal emotional tone seems to be more effective to comply with the precautions.
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Affiliation(s)
- Mehmet Hakan TÜRKÇAPAR
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
| | - Yasemin KAHYA
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
| | - Tuğba ÇAPAR-TAŞKESEN
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
| | - Hatice IŞIK
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, AnkaraTurkey
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30
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Brierley MEE, Albertella L, Rotaru K, Destree L, Thompson EM, Liu C, Christensen E, Lowe A, Segrave RA, Richardson KE, Kayayan E, Chamberlain SR, Grant JE, Lee RSC, Hughes S, Yücel M, Fontenelle LF. The role of psychological distress in the relationship between lifestyle and compulsivity: An analysis of independent, bi-national samples. CNS Spectr 2021; 28:1-10. [PMID: 34895362 PMCID: PMC7614722 DOI: 10.1017/s1092852921001048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Poor mental health is a state of psychological distress that is influenced by lifestyle factors such as sleep, diet, and physical activity. Compulsivity is a transdiagnostic phenotype cutting across a range of mental illnesses including obsessive-compulsive disorder, substance-related and addictive disorders, and is also influenced by lifestyle. Yet, how lifestyle relates to compulsivity is presently unknown, but important to understand to gain insights into individual differences in mental health. We assessed (a) the relationships between compulsivity and diet quality, sleep quality, and physical activity, and (b) whether psychological distress statistically contributes to these relationships. METHODS We collected harmonized data on compulsivity, psychological distress, and lifestyle from two independent samples (Australian n = 880 and US n = 829). We used mediation analyses to investigate bidirectional relationships between compulsivity and lifestyle factors, and the role of psychological distress. RESULTS Higher compulsivity was significantly related to poorer diet and sleep. Psychological distress statistically mediated the relationship between poorer sleep quality and higher compulsivity, and partially statistically mediated the relationship between poorer diet and higher compulsivity. CONCLUSIONS Lifestyle interventions in compulsivity may target psychological distress in the first instance, followed by sleep and diet quality. As psychological distress links aspects of lifestyle and compulsivity, focusing on mitigating and managing distress may offer a useful therapeutic approach to improve physical and mental health. Future research may focus on the specific sleep and diet patterns which may alter compulsivity over time to inform lifestyle targets for prevention and treatment of functionally impairing compulsive behaviors.
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Affiliation(s)
- Mary-Ellen E Brierley
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Kristian Rotaru
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
- Monash Business School, Monash University, Caulfield, Victoria, Australia
| | - Louise Destree
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Emma M Thompson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Amelia Lowe
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Rebecca A Segrave
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Karyn E Richardson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Edouard Kayayan
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, United Kingdom
- Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Jon E Grant
- Department of Psychiatry and Behavioural Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Rico S C Lee
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Sam Hughes
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
| | - Leonardo F Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Victoria, Australia
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
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31
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Fontenelle LF, Muhlbauer JE, Albertella L, Eppingstall J. The impact of coronavirus on individuals with problematic hoarding behaviours. J Psychiatr Res 2021; 144:405-411. [PMID: 34741838 PMCID: PMC8554288 DOI: 10.1016/j.jpsychires.2021.10.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/24/2021] [Accepted: 10/27/2021] [Indexed: 10/24/2022]
Abstract
We aimed at investigating the impact of the coronavirus pandemic on individuals with problematic hoarding behaviors. One hundred seventeen subjects with hoarding problems responded to the Coronavirus Stressful and Traumatic Rating Scale (COROTRAS), an instrument that quantified the number of coronavirus-related events, whether they were experienced as stressful, and the range of emotions resulting from them. The research subjects also answered self-report tools to evaluate the severity of hoarding, hoarding beliefs/motivations, social support, self-efficacy, internalized stigma, and other psychopathological symptoms. The number of stressful coronavirus-related events was predicted by lower age at onset of hoarding, decreased social support, greater severity of obsessive-compulsive symptoms, and lower intensity of concerns over memory as drivers of hoarding. Two emotional states experienced in the aftermath of trauma, namely greater helplessness and lower sadness, and higher depression, anxiety and distress, predicted greater severity of hoarding. In conclusion, we were able to find significant associations between hoarding disorder phenotypes and covid-19 related stressful events.
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Affiliation(s)
- Leonardo F. Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia,Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) & D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil,Corresponding author. Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Julia E. Muhlbauer
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) & D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Jan Eppingstall
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
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32
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Ojalehto HJ, Abramowitz JS, Hellberg SN, Butcher MW, Buchholz JL. Predicting COVID-19-related anxiety: The role of obsessive-compulsive symptom dimensions, anxiety sensitivity, and body vigilance. J Anxiety Disord 2021; 83:102460. [PMID: 34352520 PMCID: PMC8318675 DOI: 10.1016/j.janxdis.2021.102460] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/02/2021] [Accepted: 07/27/2021] [Indexed: 01/18/2023]
Abstract
The novel coronavirus disease (COVID-19), first detected in December of 2019 and declared a global pandemic in March of 2020, continues to pose a serious threat to public health and safety worldwide. Many individuals report anxiety in response to this threat, and at high levels, such anxiety can result in adverse mental health outcomes and maladaptive behavioral responses that have consequences for the health of communities more broadly. Predictors of excessive anxiety in response to COVID-19 are understudied. Accordingly, the present study examined psychological factors that predict more intense COVID-19-related anxiety. 438 community members completed measures assessing COVID-19-related anxiety as well as psychological variables hypothesized to predict anxious responding to the threat of COVID-19. As expected, obsessive-compulsive symptoms related to contamination, the fear of arousal-related body sensations (i.e., anxiety sensitivity), and body vigilance each predicted more severe anxiety related to the pandemic. Obsessive-compulsive symptoms related to responsibility for causing harm also emerged as a predictor. Study limitations and implications are discussed.
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Affiliation(s)
| | - Jonathan S. Abramowitz
- Corresponding author at: Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Campus Box 3270 (Davie Hall), Chapel Hill, NC 27599, United States
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Fineberg NA, Pellegrini L, Wellsted D, Hall N, Corazza O, Giorgetti V, Cicconcelli D, Theofanous E, Sireau N, Adam D, Chamberlain SR, Laws KR. Facing the "new normal": How adjusting to the easing of COVID-19 lockdown restrictions exposes mental health inequalities. J Psychiatr Res 2021; 141:276-286. [PMID: 34271458 PMCID: PMC7611491 DOI: 10.1016/j.jpsychires.2021.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/24/2021] [Accepted: 07/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Re-establishing societal norms in the wake of the COVID-19 pandemic will be important for restoring public mental health and psychosocial wellbeing as well as economic recovery. We investigated the impact on post-pandemic adjustment of a history of mental disorder, with particular reference to obsessive-compulsive (OC) symptoms or traits. METHODS The study was pre-registered (Open Science Framework; https://osf.io/gs8j2/). Adult members of the public (n = 514) were surveyed between July and November 2020, to identify the extent to which they reported difficulties re-adjusting as lockdown conditions eased. All were assessed using validated scales to determine which demographic and mental health-related factors impacted adjustment. An exploratory analysis of a subgroup on an objective online test of cognitive inflexibility was also performed. RESULTS Adjustment was related to a history of mental disorder and the presence of OC symptoms and traits, all acting indirectly and statistically-mediated via depression, anxiety and stress; and in the case of OC symptoms, also via COVID-related anxiety (all p < 0.001). One hundred and twenty-eight (25%) participants reported significant adjustment difficulties and were compared with those self-identifying as "good adjusters" (n = 231). This comparison revealed over-representation of those with a history or family history of mental disorder in the poor adjustment category (all p < 0.05). 'Poor-adjusters' additionally reported higher COVID-related anxiety, depression, anxiety and stress and OC symptoms and traits (all p < 0.05). Furthermore, history of mental disorder directly statistically mediated adjustment status (p < 0.01), whereas OC symptoms (not OC traits) acted indirectly via COVID-related anxiety (p < 0.001). Poor-adjusters also showed evidence of greater cognitive inflexibility on the intra-extra-dimensional set-shift task. CONCLUSION Individuals with a history of mental disorder, OC symptoms and OC traits experienced greater difficulties adjusting after lockdown-release, largely statistically mediated by increased depression, anxiety, including COVID-related anxiety, and stress. The implications for clinical and public health policies and interventions are discussed.
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Affiliation(s)
- Naomi A. Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom,Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, United Kingdom,University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, United Kingdom; Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - David Wellsted
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Natalie Hall
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Valentina Giorgetti
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Dorotea Cicconcelli
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Elena Theofanous
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Nick Sireau
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - David Adam
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Samuel R. Chamberlain
- University of Southampton, Department of Psychiatry, Faculty of Medicine, Southampton, United Kingdom,Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Keith R. Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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