Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Symptom Severity Changes in Obsessive-Compulsive Patients during COVID-19 Pandemic Are Associated with Shorter Illness Duration and Benzodiazepine Use: Possible Evolutionary Advantage of a Psychiatric Disorder

Giordano D’Urso
* ,
Alfonso Magliacano
ORCID logo ,
Marco Manzo
ORCID logo ,
Mattia Vittorio Pomes
,
Carla Iuliano
,
Felice Iasevoli
,
Bernardo Dell'Osso
,
Andrea De Bartolomeis
Version 1 : Received: 1 March 2024 / Approved: 1 March 2024 / Online: 1 March 2024 (17:40:36 CET)

A peer-reviewed article of this Preprint also exists.

D’Urso, G.; Magliacano, A.; Manzo, M.; Pomes, M.V.; Iuliano, C.; Iasevoli, F.; Dell’Osso, B.; de Bartolomeis, A. Impact of Benzodiazepines and Illness Duration on Obsessive–Compulsive Disorder during COVID-19 in Italy: Exploring Symptoms’ Evolutionary Benefits. Brain Sci. 2024, 14, 338. D’Urso, G.; Magliacano, A.; Manzo, M.; Pomes, M.V.; Iuliano, C.; Iasevoli, F.; Dell’Osso, B.; de Bartolomeis, A. Impact of Benzodiazepines and Illness Duration on Obsessive–Compulsive Disorder during COVID-19 in Italy: Exploring Symptoms’ Evolutionary Benefits. Brain Sci. 2024, 14, 338.

Abstract

Obsessive–compulsive disorder (OCD) is believed to follow a waxing and waning course, often according to environmental stressors. During the COVID-19 pandemic, pre-existing OCD symptoms were reported to increase and to change from checking to washing behaviors, while new-onset symptoms were predominantly of the hoarding type. In the present study, we followed the evolution of OCD symptoms, anxiety, depression, and insight of illness in forty-six OCD patients throughout the pandemic. Clinical measures were collected at four different time points before and during the COVID-19 pandemic in Italy. Within-subject comparisons were used to compare clinical scale scores across time, and correlations were examined between patients' baseline characteristics and changes in clinical scores. We found that all clinical measures increased during the first Italian lockdown, with respect to the pre-pandemic values. Anxiety decreased during the temporary elimination of restriction provisions, whereas severity of OCD symptoms and insight returned to pre-pandemic values during the second mandatory lockdown. These results were observed only in two sub-groups of patients: those taking benzodiazepines and those with shorter illness duration. Our findings suggest the need of additional clinical attention to these specific sub-groups of OCD patients in case of particularly distressing circumstances, while pointing to a possible adaptive role of their OCD symptoms when the environment requires a higher care of hygiene and extraordinary supply of essential resources.

Keywords

obsessive-compulsive disorder; COVID-19; clinical evolution; adaptive psychopathology; illness duration; anxious diathesis

Subject

Medicine and Pharmacology, Psychiatry and Mental Health

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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