%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 22
%N 9
%P e21915
%T Effects of the COVID-19 Pandemic on Obsessive-Compulsive Symptoms Among University Students: Prospective Cohort Survey Study
%A Ji,Guangjun
%A Wei,Wenjun
%A Yue,Kai-Chen
%A Li,Heng
%A Shi,Li-Jing
%A Ma,Jian-Dong
%A He,Chen-Yang
%A Zhou,Sheng-Sheng
%A Zhao,Zongya
%A Lou,Tao
%A Cheng,Jie
%A Yang,Shi-Chang
%A Hu,Xian-Zhang
%+ The Second Affiliated Hospital of Xinxiang Medical University, No 388, Jianshe Road, Muye District, Xinxiang City, 453002, China, 86 13938744850, huxianzhang@xxmu.edu.cn
%K COVID-19
%K fear
%K anxiety
%K obsessive-compulsive disorder
%K OCD
%K Yale-Brown Obsessive-Compulsive Scale
%K university student
%K mental health
%D 2020
%7 30.9.2020
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: The COVID-19 pandemic is associated with common mental health problems. However, evidence for the association between fear of COVID-19 and obsessive-compulsive disorder (OCD) is limited. Objective: This study aimed to examine if fear of negative events affects Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores in the context of a COVID-19–fear-invoking environment. Methods: All participants were medical university students and voluntarily completed three surveys via smartphone or computer. Survey 1 was conducted on February 8, 2020, following a 2-week-long quarantine period without classes; survey 2 was conducted on March 25, 2020, when participants had been taking online courses for 2 weeks; and survey 3 was conducted on April 28, 2020, when no new cases had been reported for 2 weeks. The surveys comprised the Y-BOCS and the Zung Self-Rating Anxiety Scale (SAS); additional items included questions on demographics (age, gender, only child vs siblings, enrollment year, major), knowledge of COVID-19, and level of fear pertaining to COVID-19. Results: In survey 1, 11.3% of participants (1519/13,478) scored ≥16 on the Y-BOCS (defined as possible OCD). In surveys 2 and 3, 3.6% (305/8162) and 3.5% (305/8511) of participants had scores indicative of possible OCD, respectively. The Y-BOCS score, anxiety level, quarantine level, and intensity of fear were significantly lower at surveys 2 and 3 than at survey 1 (P<.001 for all). Compared to those with a lower Y-BOCS score (<16), participants with possible OCD expressed greater intensity of fear and had higher SAS standard scores (P<.001). The regression linear analysis indicated that intensity of fear was positively correlated to the rate of possible OCD and the average total scores for the Y-BOCS in each survey (P<.001 for all). Multiple regressions showed that those with a higher intensity of fear, a higher anxiety level, of male gender, with sibling(s), and majoring in a nonmedicine discipline had a greater chance of having a higher Y-BOCS score in all surveys. These results were redemonstrated in the 5827 participants who completed both surveys 1 and 2 and in the 4006 participants who completed all three surveys. Furthermore, in matched participants, the Y-BOCS score was negatively correlated to changes in intensity of fear (r=0.74 for survey 2, P<.001; r=0.63 for survey 3, P=.006). Conclusions: Our findings indicate that fear of COVID-19 was associated with a greater Y-BOCS score, suggesting that an environment (COVID-19 pandemic) × psychology (fear and/or anxiety) interaction might be involved in OCD and that a fear of negative events might play a role in the etiology of OCD. 
%M 32931444
%R 10.2196/21915
%U http://www.jmir.org/2020/9/e21915/
%U https://doi.org/10.2196/21915
%U http://www.ncbi.nlm.nih.gov/pubmed/32931444