Lay Summary

1. A web-based survey spread throughout the internet during the first epidemic peak in Italy to assess the impact of the COVID-19 pandemic on obsessive-compulsive symptoms in the general population. 2. We found high rates (38,9%) of clinically relevant obsessive-compulsive symptoms, particularly in the contamination domain, associated with different covid-related stressful events. 3. These findings suggest the need to investigate further obsessive-compulsive symptoms trajectories in the general population, with the potential to help in the design of strategies to mitigate the long-term impact of the pandemic.

Background

The impact of the COVID-19 pandemic on obsessive-compulsive symptoms (OCS) is unclear. This study investigated OCS in the Italian general population during the initial stage of the pandemic and the impact of COVID-19 related potential risk factors.

Methods

A web-based survey spread throughout the internet between March 27th and April 9th 2020; 20241 individuals completed the questionnaire, 80.6% women. The Dimensional Obsessive-Compulsive Scale (DOCS) was included to assess the severity of the OCS domains. Further, selected outcomes were depression, anxiety, insomnia, perceived stress, and COVID-19 related stressful life events. 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.

Results

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. Depression, anxiety, perceived stress symptoms, insomnia, and different COVID-19 related stressful events were associated with OCS.

Conclusion

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.