The Necessity of Preventing Obsessive-Compulsive Disorder During the COVID-19 Pandemic


avatar Farzad Zareie ORCID 1 , *

Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Science, Kermanshah, Iran

how to cite: Zareie F. The Necessity of Preventing Obsessive-Compulsive Disorder During the COVID-19 Pandemic. Iran J Psychiatry Behav Sci. 2020;14(3):e104749.

Dear Editor,

The new coronavirus, as an acute and severe respiratory syndrome, was first identified in December 2019 in Wuhan, China, and rapidly spread to other parts of China and also other countries (1, 2). It commonly has the following symptoms: fatigue, fever, cough, shortness of breath, and headache (1) that normally appear after an incubation period of 4 - 6 days (3). COVID-19 has higher transmissibility than MERS and SARS, and each patient can infect about 5.7 individuals (4). The World Health Organization (WHO) has made several recommendations to prevent the spread of COVID-19, including an emphasis on frequent cleaning of hands using soap and water that can effectively remove pathogens from the surface of the skin (4, 5). This recommendation and what is referred to as a preventative measure against COVID-19 in vulnerable persons, including people with predisposing conditions like anxiety disorders, can have serious consequences such as obsessive-compulsive disorder (6, 7).

Obsessive-Compulsive Disorder (OCD) is a chronic, costly, and debilitating mental disorder characterized by time-consuming, stressful, and overwhelming obsessions and compulsions. Compulsions are repetitive mental acts or behaviors that aim at preventing or alleviating anxiety or preventing scary events from occurring (8). As known, OCD is associated with genetic factors and a variety of environmental factors such as fear of pollution, the feeling of being contaminated, and excessive washing (7, 9). What is important is that a stressful event can trigger a chronic pattern of OCD (10). Today, contracting COVID-19 is a scary event, and the emphasis on recommended health advice for infection prevention can cause or exacerbate OCD in people who are susceptible to it, especially Iranian women in whom OCD is relatively common (11). Therefore, nurses have a special role, including:

Educational activities: for people who are at risk of developing OCD, nurses should give health advice, such as the importance of promoting social distancing and avoid of contact with individuals who are suspected of having COVID-19 to reduce intrusive thoughts. Besides, nurses can reassure people that hand washing is not necessary when they are in sterile environments or home quarantine. Moreover, given that the COVID-19 pandemic has lasted for a long period, healthcare providers need to pay special attention to psychological complications, including obsessions and compulsions in people at risk.

Following up pharmacological treatments: for those patients who are taking medications, e.g., SSRI (10), nurses should emphasize the importance of regular consumption of medications to prevent the exacerbation of OCD.

Following up non-pharmacological treatments: Emotion-focused therapy and behavioral approaches such as “excessive-response prevention in exposed patients” can be effective and must continue.



  • 1.

    Karimian M, Borji M, Otaghi M, Mansouri F, Solaimanizadeh L, Salimi E, et al. Special Attention to Psychiatric Centers in COVID-19 Pandemic. Archives of Clinical Infectious Diseases. 2020;15(2).

  • 2.

    Nouri L, Tarjoman A, Borji M, Mahdikhani S, Soltany B, Khorshidi A, et al. Prevalence of different pain patterns in patients with COVID-19: A systematic review and meta-analysis. Anaesthesia, Pain & Intensive Care. 2020;24(2):141-50.

  • 3.

    Badakhsh B, Mansouri F. Alarm for are of Patients with Diabetes Following COVID-19 Pandemy. Arch Clin Infect Dis. 2020;15(2).

  • 4.

    Yan Y, Shin WI, Pang YX, Meng Y, Lai J, You C, et al. The First 75 Days of Novel Coronavirus (SARS-CoV-2) Outbreak: Recent Advances, Prevention, and Treatment. Int J Environ Res Public Health. 2020;17(7). [PubMed ID: 32235575]. [PubMed Central ID: PMC7177691].

  • 5.

    Harvard University. The Handiwork of Good Health. Cambridge M, USA: Harvard Health Publishing; 2007.

  • 6.

    Fineberg NA, Hengartner MP, Bergbaum C, Gale T, Rossler W, Angst J. Lifetime comorbidity of obsessive-compulsive disorder and sub-threshold obsessive-compulsive symptomatology in the community: impact, prevalence, socio-demographic and clinical characteristics. Int J Psychiatry Clin Pract. 2013;17(3):188-96. [PubMed ID: 23428236].

  • 7.

    Kumar A, Somani A. Dealing with Corona virus anxiety and OCD. Asian J Psychiatr. 2020;51:102053. [PubMed ID: 32302962]. [PubMed Central ID: PMC7151537].

  • 8.

    Gillan CM, Fineberg NA, Robbins TW. A trans-diagnostic perspective on obsessive-compulsive disorder. Psychol Med. 2017;47(9):1528-48. [PubMed ID: 28343453]. [PubMed Central ID: PMC5964477].

  • 9.

    Ahmari SE, Dougherty DD. Dissecting Ocd Circuits: From Animal Models to Targeted Treatments. Depress Anxiety. 2015;32(8):550-62. [PubMed ID: 25952989]. [PubMed Central ID: PMC4515165].

  • 10.

    Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, et al. Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Curr Neuropharmacol. 2019;17(8):710-36. [PubMed ID: 30101713]. [PubMed Central ID: PMC7059159].

  • 11.

    Amani M, Abolghasemi A, Ahadi B, Narimani M. The prevalence of obsessive-compulsive disorder among the women 20 to 40 years old of Ardabil city, Western part of Iran. Journal of Fundamentals of Mental Health. 2013;15(59):233-42.