An Analysis of Drinking Motives in the Maintenance of Co-Occurring Obsessive-Compulsive Symptoms and Alcohol Misuse.

Objective: Despite the commonly observed co-occurrence of obsessive-compulsive symptoms (OCS) and substance use in clinical populations, few researchers have examined potential mechanisms which contribute to this relationship. This study assessed the mediating role of drinking motives in the relationship between OCS, alcohol consumption, and its resulting health risks among U.S. adults. Methods: Adult participants (n = 1966; Mage = 47.72, SD = 17.91; 76.30% female; 86.10% non-Hispanic White) sourced from Research Match answered an online questionnaire containing measures related to substance use and anxiety-related symptoms. Results: As hypothesized, there was a significant positive indirect path between OCS and both alcohol consumption and risky alcohol use through coping motives. However, there were also small indirect effects of OCS through social motivations for consumption and conformity motivations for risky alcohol use. Conclusions: These results add evidence that coping motives play a role in OCS and alcohol misuse and highlights the need to also consider drinking motives related to social facilitation and conformity in those with co-occurring OCS and alcohol misuse.

Religious scrupulosity and early maladaptive schemas: a network analysis.

Scrupulosity is treated as a particular presentation of the symptomatology characteristic for obsessive-compulsive disorder (OCD). However, typical treatment of OCD (e.g. cognitive-behavioral therapy) is less effective in the case of religious scruples. Recently, schema therapy has appeared as an alternative effective treatment in obsessive-compulsive symptomatology. The present study investigated the associations between early maladaptive schemas (EMSs) and scrupulosity in a non-clinical sample of 376 poles. The participants assessed their EMSs with the Young Schema Questionnaire 3 - Short Form and their scrupulosity with the Pennsylvania Inventory of Scrupulosity. We used network analysis to control for the EMS interconnectivity. We showed that accounting for the interactions within the EMSs, three schemas, namely, Punitiveness, Subjugation, and Enmeshment/Undeveloped Self, were positively correlated with scrupulosity. Given the central position of the Negativity/Pessimism schema in the examined network, we suggested that activation of this schema could be indirectly correlated to scruples via an escalation of activation to the Punitiveness, Subjugation, and Enmeshment schemas. The findings suggest that dependency and fear of rejection problems (present in Subjugation and Enmeshment EMSs) and over-compensation by perfectionism (present in Punitiveness EMS) could be addressed in the treatment of scruples.

Obsessive-Compulsive Symptoms: Baseline Prevalence, Comorbidity, and Implications in a Clinically Anxious Pediatric Sample.

Subclinical symptoms of obsessive-compulsive disorder (i.e., obsessive compulsive symptoms, or "OCS") cause functional impairment, including for youth without full-syndrome OCD. Further, despite high rates of OCS in youth with anxiety disorders, knowledge of OCS in the context of specific anxiety disorders is limited. The present study seeks to: (1) compare OCS in pediatric patients with anxiety disorders and healthy youth, (2) determine which categorical anxiety disorder(s) associate most with OCS, and (3) determine relationships between OCS with anxiety severity and impairment. Data on OCS, anxiety, and functional impairment were collected from 153 youth with anxiety disorders and 45 healthy controls, ages 7-17 years (M = 11.84, SD = 3.17). Findings indicated that patients had significantly more OCS than healthy controls. Among patients, GAD was a significant predictor of OCS as well as OCD risk. These results suggest that OCS should be a primary diagnostic and treatment consideration for youth who present in clinical settings with GAD.

A systematic review and meta-analysis of the relationship between obsessive-compulsive symptoms and symptoms of proposed orthorexia nervosa: The contribution of assessments.

OBJECTIVE: This systematic review and meta-analysis aimed to update the literature on orthorexia nervosa (ON), a proposed diagnosis of pathologically 'healthy' eating, by critically analysing the current evidence for the relationship between ON and obsessive-compulsive (OC) symptoms. Further, this paper aimed to compare the ON/OC relationship significance and strength based on when the ON measurement tool was developed. METHOD: PsycINFO, PubMed and Web of Science databases were queried for quantitative, peer-reviewed studies recruiting adult participants, published in English up to April 2023. Studies not directly comparing ON and OC symptoms were excluded. After full-text review and quality assessment, 40 studies were included in the systematic review and 31 studies in the meta-analysis. RESULTS: ON assessments created prior to the 2016 revised ON diagnostic criteria do not appear to fully capture OC symptoms. Studies using earlier developed ON assessments demonstrated inconsistent ON/OC relationships whereas studies implementing more recent assessments (from 2018 onwards) found consistently significant, larger relationships, highlighting a previously underrated OC component of ON. CONCLUSIONS: Early ON studies, and studies utilising early ON assessments should be interpreted with caution, particularly in relation to OC symptom involvement in ON. Future research should validate novel ON assessments and investigate common underlying factors.

A closer look: obsessive-compulsive symptoms among intern nurses amidst COVID-19 pandemic.

BACKGROUND: The distinctive circumstances and socio-cultural context in Egypt make it crucial to explore the psychological well-being of intern nurses amid the COVID-19 pandemic, with a specific focus on obsessive-compulsive symptoms. This study aimed to investigate the influence of fear of COVID-19 on obsessive-compulsive symptoms among intern nurses. METHODS: A cross-sectional survey involving 375 randomly recruited intern nurses was conducted. Data collected included the Fear of COVID-19 Scale and the Short Version of the Arabic Obsessive-Compulsive Scale. RESULTS: A significant relationship was found between the fear of COVID-19 and the severity of obsessive-compulsive symptoms among the participants (r = 0.472, p = 0.000). A stepwise regression analysis indicated that the fear of COVID-19, living in urban regions, frequency of COVID-19 infection, and increased number of infected family members may contribute to the severity of Obsessive-Compulsive Symptoms with adjusted R2 value = 27.5%. CONCLUSION: The findings suggest that the COVID-19 pandemic has had significant psychological impacts on newly qualified nurses during their internship training period, including the manifestation of mental health symptoms such as Obsessive-Compulsive Symptoms. It was observed that urban residents, intern nurses with recurrent COVID-19 infections, and those with more infected family members exhibited a higher severity of OCS. These findings underscore the need for further research to investigate additional factors that may influence OCS severity.

The Role of Obsessive Compulsive Traits in Fibromyalgia: Is Pain-Related Obsessive Ideation Involved in Pathogenesis?

Background and Objectives: Fibromyalgia syndrome (FMS) is defined as a chronic pain syndrome that is characterized by widespread pain, tenderness, and diffuse stiffness. In addition, neuropsychological symptoms such as fatigue, sleep disorders, poor mood, cognitive impairment, and headaches are often reported. Many reports have addressed the coexistence of affective disorders and anxiety with FMS, yet few have focused on its association with obsessive compulsive disorder (OCD). We investigated the occurrence of classical patterns of OCD in participants with FMS and assessed their effect on pain perception and functional impairment. Material and Methods: The research population included 37 patients diagnosed with FMS, treated at the Rheumatology Clinic in the Sheba Medical Center, Tel-Hashomer, Israel. We used validated questionnaires including a demographic questionnaire, a questionnaire on average and maximal pain intensity, the Eysenck Personality Questionnaire-Revised (EPQ-R), the Perceived Stress Scale, the Pain Catastrophizing Scale, the Pain Obsessive questionnaire, and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results: Patients with FMS were found to have intrusive and obsessive thoughts regarding pain for several hours every day, causing a high degree of anxiety and high levels of pain, catastrophizing, and magnification, leading to helplessness and functional impairment. In total, 27% of the patients reported severe malfunction due to pain and pain ideation, and 49% demonstrated mild obsessive compulsive symptoms that were strongly correlated with pain intensity and functional impairment. Conclusions: Obsessive compulsive thinking patterns contribute to pain magnification and to the cognitive aspects of fibromyalgia syndrome.

Clozapine-related obsessive-compulsive symptoms and their impact on wellbeing: a naturalistic longitudinal study.

BACKGROUND: Obsessive-compulsive symptoms (OCS) are commonly associated with clozapine treatment but are frequently overlooked by clinicians despite their potential impact on patients' quality of life. In this study, we explored whether OCS severity impacted subjective wellbeing and general functioning, independently of depressive and psychotic symptoms. METHODS: We used anonymised electronic healthcare records from a large cohort of patients who were treated with clozapine and assessed annually for OCS, wellbeing, general functioning, and psychopathology using standardised scales as part of routine clinical practice. We used statistical mixed linear model techniques to evaluate the longitudinal influence of OCS severity on wellbeing and general functioning. RESULTS: A total of 184 patients were included, with 527 face-to-face assessments and 64.7% evaluated three or more times. Different linear mixed models demonstrated that OCS in patients treated with clozapine were associated with significantly worse wellbeing scores, independently of depression and psychotic symptoms, but OCS did not impair general functioning. Obsessional thinking and hoarding behaviour, but not compulsions, were significantly associated with the impact on wellbeing, which may be attributable to the ego-syntonic nature of the compulsions. CONCLUSIONS: Given the frequent occurrence of OCS and their negative impact on wellbeing, we encourage clinicians to routinely assess and treat OCS in patients who are taking clozapine.

Reward functioning from an attentional perspective and obsessive-compulsive symptoms-an eye-tracking study.

BACKGROUND: Recently, a novel approach to obsessive-compulsive disorder has emerged, implicating altered reward functioning in the disorder. Yet, no study to date has directly examined the attentional aspect of reward functioning in participants with obsessive-compulsive (OC) symptoms, with past research mostly relying on reaction-time-based tasks. METHODS: A reward-based value-modulated attentional capture task was completed by a sample of nonclinical student participants-44 with high (HOC) and 48 with low (LOC) levels of OC symptoms. We measured the extent to which high and low reward-signaling distractors captured attention and impaired performance on the task, resulting in a lower possibility of obtaining a monetary reward. Attentional capture was indexed via fixation data, and further explored using saccade data. RESULTS: Both groups performed more poorly when a high-reward signaling distractor was present, compared to when a low-reward signaling distractor was present. Importantly, this difference was significantly greater in the HOC group, and was found to be driven by the specific effects of reward-signaling distractors. Similar results emerged when exploring saccade data, and remained significant after controlling for both addiction-related compulsivity and depressive symptoms. CONCLUSIONS: Current findings suggest that attentional reward-related functioning may be associated with OC symptoms. Different aspects of reward functioning, including attention, should be further explored and incorporated into future research and clinical endeavors.

Hoarding behavior and its association with mental health and functioning in a large youth sample.

Hoarding behavior is prevalent in children and adolescents, yet clinicians do not routinely inquire about it and youth may not spontaneously report it due to stigma. It is unknown whether hoarding behavior, over and above obsessive-compulsive symptoms (OCS), is associated with major clinical factors in a general youth population. This observational study included N = 7054 youth who were not seeking help for mental health problems (ages 11-21, 54% female) and completed a structured interview that included evaluation of hoarding behavior and OCS, as a part of the Philadelphia Neurodevelopmental Cohort between November 2009 and December 2011. We employed regression models with hoarding behavior and OCS (any/none) as independent variables, and continuous (linear regression) or binary (logistic regression) mental health measures as dependent variables. All models covaried for age, sex, race, and socioeconomic status. A total of 374 participants endorsed HB (5.3%), most of which reported additional OCS (n = 317). When accounting for OCS presence, hoarding behavior was associated with greater dimensional psychopathology burden (i.e., higher P-factor) (ß = 0.19, p < .001), and with poorer functioning (i.e., lower score on the child global assessment scale) (ß = - 0.07, p < .001). The results were consistent when modeling psychopathology using binary variables. The results remained significant in sensitivity analyses accounting for count of endorsed OCS and excluding participants who met criteria for obsessive-compulsive disorder (n = 210). These results suggest that hoarding behavior among youth is associated with poorer mental health and functioning, independent of OCS. Brief hoarding-behavior assessments in clinical settings may prove useful given hoarding behavior's stigma and detrimental health associations.

Genetic influences on the interplay between obsessive-compulsive behavior symptoms and cannabis use during adolescence.

INTRODUCTION: There are overlapping biological origins and behaviors associated with obsessive-compulsive symptoms (OCS) and cannabis use. There is also evidence that OCS and cannabis use are associated over time. Thus, we investigated polygenic predisposition for OCS as predictive of OCS and cannabis use from age 17 to 19. We hypothesized that greater genetic risk for OCS would predict both OCS and cannabis use. METHODS: The current study used participants from the Project Alliance 1 study, a US-based sample, for whom genomic, OCS, and cannabis use data were available (n = 547). Polygenic risk scores (PRS) were formed via a meta-genome-wide association study on OCS and examined as a predictor of OCS and cannabis use at age 17 and 19. The sample was diverse (52.4% male; 45% European American, 30% African American, 14% multiracial, 5% Hispanic/Latino, 4% Asian American, and 2% other groups). Sensitivity analysis was performed by gender for European American and African American subsamples. RESULTS: Across the whole sample, the greater polygenic risk for OCS was negatively associated with cannabis use at age 17 and positively associated with OCS at 19. Cannabis use at age 17 was positively associated with OCS at age 19. The association between polygenic risk for OCS and cannabis use at age 17 was replicated in European American males, whereas the association between cannabis use at age 17 and OCS at age 19 was replicated in African American males. CONCLUSIONS: Cannabis use may exacerbate OCS through adolescence, and genetic predisposition for OCS may be associated with lower cannabis use in efforts to avoid exacerbation of OCS.

A pilot study of experiencing racial microaggressions, obsessive-compulsive symptoms, and the role of psychological flexibility.

BACKGROUND: Experiencing racial microaggressions has clear effects on physical and psychological health, including obsessive-compulsive disorder symptoms (OCS). More research is needed to examine this link. Psychological flexibility is an important process to examine in this work. AIMS: This study aimed to examine if, while controlling for depression and anxiety, experiences of microaggressions and psychological flexibility helped explain OCD symptoms within a university-affiliated sample (undergraduate, graduate and law students). This was a pilot exploration of the relationships across themes. METHOD: Initial baseline data from a longitudinal study of psychological flexibility, OCD symptoms, depression, anxiety and experience of microaggressions was utilized. Correlations and regressions were utilized to examine which OCD symptom dimensions were associated with experiencing racial microaggressions in addition to anxiety and depression, and the added role of psychological flexibility was examined. RESULTS: OCD symptoms, experiences of microaggressions and psychological flexibility were correlated. Experiences of racial microaggressions explained responsibility for harm and contamination OCD symptoms above and beyond psychological distress. Exploratory results support the relevance of psychological flexibility. CONCLUSION: Results support other work that experiences of racial microaggressions help explain OCS and they add some support for psychological flexibility as a relevant risk or protective factor for mental health in marginalized populations. These topics should be studied longitudinally with continued consideration of all OCD themes, larger sample sizes, intersecting identities, clinical samples, and continued exploration of psychological flexibility and mindfulness and values-based treatments.

Childhood emotional maltreatment, maladaptive coping and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder.

Previous studies have reported childhood emotional maltreatment (CEM) to be associated with specific obsessive-compulsive (OC) symptoms, but maladaptive coping, which may be the underlying mechanism in this relationship, has not been evaluated yet. Thus, the present study aimed to examine the effects of CEM on the OC symptoms of responsibility for harm and unacceptable thoughts, as well as obsessive-compulsive disorder (OCD) severity, through maladaptive coping, including cognitive avoidance, experiential avoidance and emotional suppression in OCD patients (n = 360). The results showed that CEM had direct effects, as well as indirect effects via cognitive and experiential avoidance and emotional suppression, on responsibility for harm and unacceptable thoughts. In addition, the indirect effect of CEM on OCD severity was significantly mediated by the roles of cognitive avoidance and experiential avoidance. The present study adds new literature to evidence indicating the role of early childhood events in developing and maintaining OCD in which adverse maladaptive coping related to unpleasant childhood abuse plays an important role in OCD. More precisely, OCD patients who experience a history of CEM may further use maladaptive coping to cope with their distress and subsequently experience responsibility for harm, unacceptable thoughts and severe OCD.

Obsessional slowness in obsessive-compulsive disorder: identifying characteristics and comorbidities in a clinical sample.

BACKGROUND: Obsessional slowness (OS) is characterised by debilitating motor slowness during initiation and completion of daily tasks such as washing, dressing, eating or walking. Yet, the clinical features of OS are still poorly understood. METHODS: This study aimed to delineate demographics, comorbid disorders and obsessive-compulsive symptoms (OCS) associated with OS. Cross sectional data from 667 OCD outpatients aged 9-82 years (M = 37.86, SD = 12.78) who underwent comprehensive standardised assessments administered by trained clinicians were analysed. Participants with (n = 189) and without (n = 478) OS were compared and contrasted. RESULTS: Logistic regression revealed that being single, having tics and displaying higher severity of aggression, contamination, symmetry and hoarding symptoms significantly predicted participants having OS. CONCLUSIONS: This is the largest-scale descriptive study of OS, which also provides preliminary evidence that OS may be a more severe form of OCD. Further empirical validation of these findings is required, and future research should focus on developing OS assessment.Key PointsThis was the first large-scale descriptive study of obsessional slowness (OS), that provided preliminary evidence for an OS phenotype within obsessive-compulsive disorderOS is associated with increased severity of aggression, contamination, symmetry and hoarding obsessive-compulsive symptomsIndividuals with OS are more likely to have comorbid tics, suggesting that there may be underlying motor factors contributing to this conditionFuture research would benefit from collecting both qualitative and quantitative data when assessing OS.

Mediating role of psychological flexibility in the effect of obsessive-compulsive symptoms on sleep quality among nurses during the COVID-19 pandemic.

Front-line nurses suffered unprecedented mental distress and severe insomnia during the COVID-19 pandemic. Present study aimed to explore the relationship between obsessive-compulsive symptoms and sleep quality and examine the potential mediating role of psychological flexibility between obsessive-compulsive symptoms and sleep quality. A total of 496 nurses from a Chinese large-scale Class 3 A Comprehensive Hospital were included in an online cross-sectional survey and completed the revised obsessive-compulsive inventory (OCI-R), Multidimensional Psychological Flexibility Inventory (MPFI) and Pittsburgh Sleep Quality Index (PSQI). As predicted, obsessive-compulsive symptoms were negatively associated with psychological flexibility and sleep quality, and psychological flexibility was positively associated with sleep quality. In addition, the relationship between obsessive-compulsive symptoms and sleep quality was partially mediated by psychological flexibility, which can provide some reference for the treatment of the obsessive-compulsive disorder (OCD) and insomnia, and lead to improvements in clinical and psychotherapy planning.

Obsessive compulsive symptoms in mothers of children with atopic dermatitis.

Introduction: Maternal stress, depression and anxiety are associated with atopic dermatitis (AD) in offspring. However, the relationship between maternal obsessive compulsive symptoms (OCS) and AD in their children is unclear. Aim: To investigate whether maternal OCS are associated with AD in offspring. Material and methods: A total of 75 children with AD diagnosed by the paediatric allergist and 76 healthy children and their mothers were included in the study. A Turkish version of the Maudsley Obsessive Compulsive Inventory (MOCI-T) was used to assess OCS of mothers in both groups. Results: Total MOCI-T score and slowness, doubt, and rumination subscale scores were higher in the AD group than in the healthy group (p = 0.007, p = 0.001, p = 0.012 and p = 0.011, respectively) but washing/cleaning and checking subscale scores did not reach a statistically significant difference (p = 0.203 and p = 0.053, respectively). There was no correlation between SCORing Atopic Dermatitis (SCORAD) and MOCI-T/subscales scores. Conclusions: Our study provides evidence for associations between maternal OCS and infantile AD. The findings support recommendations for psychosocial support of mothers of children with AD.

Obsessive-compulsive symptoms in ACTG1-associated Baraitser-Winter cerebrofrontofacial syndrome.

Symptoms of obsessive-compulsive disorder (OCD) may rarely occur in the context of genetic syndromes. So far, an association between obsessive-compulsive symptoms (OCS) and ACTG1-associated Baraitser-Winter cerebrofrontofacial syndrome has not been described as yet. A thoroughly phenotyped patient with OCS and ACTG1-associated Baraitser-Winter cerebrofrontofacial syndrome is presented. The 25-year-old male patient was admitted to in-patient psychiatric care due to OCD. A whole-exome sequencing analysis was initiated as the patient also showed an autistic personality structure, below average intelligence measures, craniofacial dysmorphia signs, sensorineural hearing loss, and sinus cavernoma as well as subtle cardiac and ophthalmological alterations. The diagnosis of Baraitser-Winter cerebrofrontofacial syndrome type 2 was confirmed by the detection of a heterozygous likely pathogenic variant in the ACTG1 gene [c.1003C > T; p.(Arg335Cys), ACMG class 4]. The automated analysis of magnetic resonance imaging (MRI) revealed changes in the orbitofrontal, parietal, and occipital cortex of both sides and in the right mesiotemporal cortex. Electroencephalography (EEG) revealed intermittent rhythmic delta activity in the occipital and right temporal areas. Right mesiotemporal MRI and EEG alterations could be caused by a small brain parenchymal defect with hemosiderin deposits after a cavernomectomy. This paradigmatic case provides evidence of syndromic OCS in ACTG1-associated Baraitser-Winter cerebrofrontofacial syndrome. The MRI findings are compatible with a dysfunction of the cortico-striato-thalamo-cortical loops involved in OCD. If a common pathophysiology is confirmed in future studies, corresponding patients with Baraitser-Winter cerebrofrontofacial syndrome type 2 should be screened for OCS. The association may also contribute to a better understanding of OCD pathophysiology.

Co-occurrence of schizo-obsessive traits and its correlation with altered executive control network functional connectivity.

The prevalence of obsessive-compulsive symptoms (OCS) in schizophrenia patients is as around 30%. Evidence suggested that mild OCS could reduce symptoms of schizophrenia, supporting the presence of compensatory functions. However, severe OCS could aggravate various impairments in schizophrenia patients, supporting the "double jeopardy hypothesis". Patients with schizo-obsessive comorbidity, schizophrenia patients and obsessive-compulsive disorder patients have been found to have similarities in executive dysfunctions and altered resting-state functional connectivity within the executive control network (ECN). Executive functions could be associated with the ECN. However, little is known as to whether such overlap exists in the subclinical populations of individuals with schizo-obsessive traits (SOT), schizotypal individuals and individuals with high levels of obsessive-compulsive symptoms (OCS). In this study, we recruited 30 schizotypal individuals, 25 individuals with OCS, 29 individuals with SOT and 29 controls for a resting-state ECN-related functional connectivity (rsFC) and a go/shift/no-go task. We found that individuals with SOT exhibited increased rsFC within the ECN compared with controls, while schizotypal individuals exhibited the opposite. Individuals with OCS exhibited decreased rsFC within the ECN and between the ECN and the default mode network (DMN), relative to controls. No significant correlational results between altered rsFC related to the ECN with executive function performance were found after corrections for multiple comparisons in three subclinical groups. Our findings showed that individuals with SOT had increased rsFC within the ECN, while schizotypal individuals and individuals with OCS showed the opposite. Our findings provide evidence for possible neural substrates of subclinical comorbidity of OCS and schizotypy.

Characterizing changes in obsessive-compulsive symptoms over the course of treatment for adolescent bulimia nervosa.

OBJECTIVE: Data suggest that obsessive-compulsive (OC) symptoms are commonly observed in adolescents with eating disorders and predict poorer treatment response. Further, emerging data among adults suggest that changes in OC symptoms relate to changes in eating disorder symptoms across treatment. Given evidence that early invention decreases risk for protracted illness, evaluating processes that may relate to treatment response will be useful in increasing the effectiveness of existing interventions. Therefore, the current investigation explored changes in general and eating disorder-specific OC symptoms throughout family-based treatment (FBT) and cognitive behavioral therapy (CBT) for bulimia nervosa (BN), as well as associations among these changes and eating disorder outcomes at follow-up. METHOD: Participants (N = 110) received 18 sessions of FBT or CBT and completed measurements of general and eating disorder-specific OC symptoms at baseline, end-of-treatment, and 6- and 12-month follow-up. RESULTS: Multilevel models indicated that across both treatments, there was no change in general OC symptoms, whereas all eating disorder-related OC symptoms decreased over treatment and follow-up. Exploratory analyses indicated that lower severity in discharge eating-disorder-specific OC symptoms contributed to lower eating pathology at follow-up. DISCUSSION: Together, findings support the efficacy of both FBT and CBT in helping to reduce eating disorder-specific OC symptoms and suggest that adjunctive intervention may be required for ameliorating general OC symptoms in this population. PUBLIC SIGNIFICANCE: BN is associated with significant increases in mortality and societal cost, and there is a pressing need for innovations within available treatments for young people with this disorder. In the current study, we explore the extent to which existing evidence-based treatments for adolescent BN are effective in targeting obsessive-compulsive symptoms, a known predictor of treatment response and common co-morbidity in this population.

Impact of the fear of Covid-19 infection on intent to breastfeed; a cross sectional survey of a perinatal population in Qatar.

OBJECTIVES: Infection control measures during the Covid-19 pandemic have focused on limiting physical contact and decontamination by observing cleaning and hygiene rituals. Breastfeeding requires close physical contact and observance of hygienic measures like handwashing. Worries around contamination increase during the perinatal period and can be expressed as increase in obsessive compulsive symptoms. These symptoms have shown to impact breastfeeding rates. This study attempts to explore any relationship between the Covid-19 pandemic and perinatal obsessive-compulsive symptomatology and whether the Covid-19 pandemic has any impact on intent to breastfeed. METHODS: A cross sectional survey of perinatal women attending largest maternity centre in Qatar was carried out during the months of October to December 2020. Socio-demographic information, intent to breastfeed and information around obsessive compulsive thoughts around Covid-19 pandemic were collected using validated tools. RESULTS: 15.7% respondents report intent to not breastfeed. 21.4% respondents reported obsessive-compulsive symptoms. 77.3% respondents believed the biggest source of infection was from others while as only 12% of the respondents believed that the source of infection was through breastfeeding and 15.7% believed the vertical transmission as the main source of risk of transmission. CONCLUSIONS: The rates of Obsessive-compulsive symptoms were increased and the rates of intent to breastfeed were decreased when compared with pre pandemic rates. The obsessive-compulsive symptoms and the intent to not breastfeed were significantly associated with fear of infection to the new-born. Obsessive-compulsive symptoms were not significantly correlated with intent to breastfeed and can be seen as adaptive strategies utilized by women to continue breastfeeding in the context of fear of infection.

Elevated risk for obsessive-compulsive symptoms in women pregnant during the COVID-19 pandemic.

The COVID-19 pandemic has led to a public mental health crisis with many people experiencing new or worsening anxiety. Fear of contagion and the lack of predictability/control in daily life increased the risk for problems such as obsessive-compulsive disorder (OCD) in the general population. Pregnant women may be particularly vulnerable to such pandemic-related stressors yet the prevalence of OC symptoms in this population during the pandemic remains unknown. We examined the prevalence of OC symptoms in a sample of 4451 pregnant women in the USA, recruited via targeted online methods at the start of the pandemic. Participants completed self-report measures including the Obsessive-Compulsive Inventory-Revised and the Pandemic-Related Pregnancy Stress Scale. Clinically significant OC symptoms were present in 7.12% of participants, more than twice as high as rates of peripartum OCD reported prior to the pandemic. Younger maternal age, income loss, and suspected SARS-CoV-2 infection were all associated with higher OC symptoms. Two types of pregnancy-specific stress, pandemic-related and pandemic-unrelated, were both associated with higher levels of OC symptoms. Pandemic-related pregnancy stress predicted OC symptoms even after controlling for non-pandemic-related, pregnancy-specific stress. Elevated rates of OC symptoms were observed in women pregnant during the pandemic, particularly those experiencing elevated pandemic-related pregnancy stress. This type of stress confers a distinct risk for OC symptoms above and beyond pregnancy-specific stress and demographic factors. Healthcare providers should be prepared to see and treat more peripartum women with OC symptoms during this and future public health crises.