Obsessive-compulsive symptoms and information seeking during the Covid-19 pandemic

The COVID-19 pandemic presented an unprecedented psychological challenge, marked by uncertainty, isolation, and disruptions across various life domains. Initial studies revealed adverse psychological consequences among individuals with and without pre-existing mental health conditions, including heightened symptoms in those with anxiety, depression, bipolar disorders, schizophrenia, and obsessive-compulsive disorder (OCD). The general public also experienced worsened mental health, primarily manifested as increased anxiety and depression levels. Obsessive-compulsive (OC) symptoms were considered particularly vulnerable to pandemic-related stressors, given their focus on contamination, infectious illnesses, and harm. While some early evidence suggested worsening OC symptoms in OCD patients during the pandemic, results were inconsistent, possibly due to the disorder's heterogeneity or comorbid conditions. The impact of the pandemic on OC symptoms in non-patient populations remained largely unknown. Research on previous health crises, like the HIV/AIDS epidemic, demonstrated that health campaigns could influence the emergence of epidemic-related OCD-like behaviors in individuals without a history of psychiatric disorders, raising concerns about similar effects from COVID-19 campaigns. It is important to note that while elevated psychiatric symptoms often follow stressful events, they usually subside over time without causing long-term impairments. This adaptive process, attributed to coping and reappraisal strategies, is crucial. Failure of this process can lead to chronic mental health problems. Therefore, understanding both the immediate increase and long-term trajectory of psychiatric symptoms during the pandemic was essential. This large-scale, longitudinal study aimed to investigate changes in OC, anxiety, and depression symptoms in a non-clinical sample of the UK public during the first COVID-19 wave. The study also examined the impact of these symptoms on pandemic-related information seeking and adherence to governmental guidelines, hypothesizing a link between OC symptoms and excessive information seeking.

Existing literature highlighted the adverse mental health consequences of the COVID-19 pandemic, showing increased symptoms in individuals with pre-existing conditions like anxiety, depression, schizophrenia, and OCD. Studies on the general population also reported a rise in anxiety and depression. However, the impact on obsessive-compulsive (OC) symptoms in non-clinical populations remained unclear. Prior research on health crises, such as the HIV/AIDS epidemic, indicated that public health campaigns might inadvertently trigger OCD-like behaviors in individuals without a prior diagnosis. This raised concerns regarding the potential for similar effects from COVID-19 related information campaigns. Furthermore, the literature established that while stressful events often lead to elevated mental health symptoms, these typically resolve over time through coping mechanisms. However, the persistence of these symptoms could lead to chronic mental health issues, underscoring the importance of longitudinal studies to track symptom trajectories.

This longitudinal online study recruited participants from the UK general public via Prolific. Data was collected at two time points: T1 (April-May 2020, near the peak of the first pandemic wave) and T2 (July-August 2020, following the easing of lockdown restrictions). Participants completed standardized questionnaires at both time points. The Padua Inventory-Washington State University Revision (PI-WSUR) measured OC symptoms, while the Hospital Anxiety and Depression Scale (HADS) assessed anxiety and depression. A new Covid-19-related information-seeking questionnaire was developed and validated, assessing information gathering from various sources. At T1, participants also reported baseline news and social media consumption and underwent a cognitive ability assessment. At T2, adherence to government guidelines was measured. A total of 406 participants completed T1, and 296 completed T2. Participants with self-reported OCD diagnoses were excluded to maintain focus on the non-clinical population. Statistical analyses included repeated-measures ANOVA to compare symptom changes over time, paired t-tests and permutation tests to compare T1 and T2 scores, robust multiple regression models to assess associations between information seeking and psychiatric scores, a mixed-effects model to examine changes in these associations over time, and a mediation analysis to investigate the relationship between OC symptoms, information seeking, and guideline adherence. Demographic variables like age, gender, education, essential worker status, and IQ were controlled for in analyses. Multicollinearity was checked using Variance Inflation Factors (VIF).

The study found that OC symptoms, anxiety, and depression scores were all elevated at T1 (the peak of the first pandemic wave). OC symptom scores (PI-WSUR), were significantly higher than those reported in previous pre-pandemic population samples. Similarly, anxiety and depression scores (HADS) were high, with a substantial portion of participants scoring above pre-pandemic clinical cutoffs. Longitudinal analysis revealed distinct trajectories for the three symptom dimensions. While depression scores decreased and anxiety scores plateaued from T1 to T2, OC symptom scores significantly increased further, even after the easing of restrictions. This increase in OC symptoms was directly linked to increased Covid-19 related information seeking at T1. Furthermore, increased information seeking at T1 was associated with greater adherence to government guidelines at T2. A mediation analysis indicated that information seeking fully mediated the relationship between OC symptoms and guideline adherence. In other words, increased OC symptoms led to increased information seeking, which then led to increased adherence to guidelines.

The findings demonstrate that the COVID-19 pandemic disproportionately affected OC symptoms in the general population, leading to a sustained increase even after restrictions eased. The strong link between increased OC symptoms and increased information seeking suggests that the heightened anxiety surrounding the pandemic fueled a compulsive need for information. This, in turn, translated into greater adherence to public health guidelines. These findings highlight the importance of considering the mental health impact of pandemics, particularly the unique vulnerability of OC symptoms. The increase in OC symptoms suggests a potential for long-term mental health consequences if not addressed appropriately. Future research should investigate intervention strategies to manage pandemic-related anxiety and reduce compulsive information seeking behaviors.

This study provides crucial evidence of the disproportionate impact of the COVID-19 pandemic on obsessive-compulsive symptoms in the general population. The observed increase in OC symptoms, linked to information seeking and subsequent guideline adherence, underscores the need for ongoing monitoring and targeted interventions to mitigate potential long-term mental health effects. Future research could focus on developing and evaluating interventions aimed at reducing compulsive information seeking and managing pandemic-related anxiety.

The study's reliance on self-reported data may introduce bias. The sample, while large, may not be fully representative of the entire UK population. The cross-sectional nature of the information seeking and guideline adherence data limits causal inference. The study focused on the first pandemic wave; findings might not generalize to subsequent waves or other similar events. The relatively short follow-up period limits conclusions on long-term effects. Lastly, the newly developed information-seeking questionnaire requires further validation in future studies.