Long-Term Impact of the COVID-19 Pandemic on Obsessive-Compulsive Disorder Symptoms in Children and Adolescents: A One-Year Follow-Up Study

Year 2025, Volume: 8 Issue: 3, 168 - 175, 28.10.2025

Murat Coşkun , Yaşar Tanır , Ali Karayağmurlu , Zeynep Nur Karadoğan , Yahya Esad Özdemir , Ömer Faruk Bulut , Pınar Karan , Saliha Büşra Selman

https://doi.org/10.26650/JARHS2025-1657050

Abstract

Objective: To examine how COVID-19 affected obsessive-compulsive disorder (OCD) symptom trajectories in children and adolescents across pre-, during-, and post-pandemic periods over one year.

Materials and Methods: Thirty-six youth with a prior diagnosis of OCD (Mage=13.5 years, SD=2.9) completed the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Clinical Global Impression-Severity (CGI-S) scale at three time points: before the pandemic, during the pandemic, and after the pandemic. Nonparametric repeated-measures tests (Friedman) with DunnBonferroni post hoc contrasts evaluated the change over time.

Results: Time effects were significant for global severity (CGIS: χ²(2)=7.35, p=0.025) and CY-BOCS total (χ²(2)=6.44, p=0.040), with descriptively highest total symptoms during the pandemic (18.66±6.73) versus pre-pandemic (14.55±5.20; p=0.08) and postpandemic (12.80±8.00; p=0.17); pairwise contrasts for totals were not significant. Obsessions showed a significant during-to-post reduction (χ²(2)=9.27, p=0.010; Dunn-Bonferroni p=0.047), with a marginal pre-to-during increase (p=0.055). Compulsion had a significant effect (χ²(2)=6.33, p=0.042), but post hoc comparisons were not significant.

Conclusion: Youth with OCD showed increased severity during the pandemic that later eased; obsessions improved post-pandemic, while total and compulsion scores showed no clear pairwise changes. This pattern indicates partial recovery and underscores the need for continued monitoring and timely evidence-based care during and after crises.

Keywords

OCD , COVID-19 , children , adolescents , obsessions , compulsion

Çocuk ve Ergenlerde COVID-19 Pandemisinin Obsesif-Kompulsif Bozukluk Belirtileri Üzerindeki Uzun Vadeli Etkisi: Bir Yıllık İzlem Çalışması

Abstract

Amaç: COVID-19’un, çocuk ve ergenlerde obsesif-kompulsif bozukluk (OKB) belirti seyirlerini pandemi öncesi, pandemi sırası ve pandemi sonrası bir yıllık izlem boyunca incelemek.

Gereç ve Yöntemler: OKB tanısı olan 36 genç (ortalama yaş=13,5, SS=2,9) pandemi öncesi, pandemi sırası ve pandemi sonrasında üç zaman noktasında değerlendirildi. Ölçümler için Çocuk Yale-Brown Obsesif Kompulsif Ölçeği (CY-BOCS) ile Klinik Genel İzlenim-Şiddet Ölçeği (CGI-S) kullanıldı. Zamana bağlı değişimi test etmek üzere parametrik olmayan tekrarlı ölçümler için Friedman testi ve DunnBonferroni düzeltmeli ikili karşılaştırmalar uygulandı.

Bulgular: Zamana bağlı etkiler, CGI-S (CGI-S: χ²(2)=7,35, p=0,025) ve CY-BOCS toplamı için anlamlıydı (χ²(2)=6,44, p=0,040); toplam belirti düzeyleri betimsel olarak pandemi sırasında en yüksekti (18,66±6,73), pandemi öncesine (14,55±5,20; p=0,08) ve pandemi sonrasına (12,80±8,00; p=0,17) kıyasla; toplam puanlar için ikili karşılaştırmalar anlamlı değildi. Obsesyonlar, pandemi sırasından pandemi sonrasına anlamlı bir azalma gösterdi (χ²(2)=9,27, p=0,010; Dunn-Bonferroni p=0,047) ve pandemi öncesinden pandemi sırasına artış marjinaldi (p=0,055). Kompulsiyonlar için genel etki anlamlıydı (χ²(2)=6,33, p=0,042), ancak post-hoc karşılaştırmalar anlamlı değildi.

Sonuç: Pandemi döneminde genel şiddet arttı ve sonrasında hafifledi; obsesyonlarda pandemi sonrası belirgin iyileşme görüldü, toplam ve kompulsiyon puanlarında ise net ikili değişimler saptanmadı. Bulgular kısmi iyileşmeye ve kriz dönemlerinde sürekli izlem ile kanıta dayalı tedavinin önemine işaret etmektedir.

Keywords

OKB , COVID-19 , çocuklar , ergenler , obsesyonlar , kompulsiyonlar

References

• Liao J, Liu L, Fu X, Feng Y, Liu W, Yue W, et al. The immediate and long-term impacts of the COVID-19 pandemic on patients with obsessive-compulsive disorder: A one-Year follow-up study. Psychiatry Res 2021;306:114268. google scholar
• World Health Organization. WHO Coronavirus (COVID-19) dashboard. 2023. Available from: https://covid19.who.int. google scholar
• Cakir B. COVID-19 in Turkey: Lessons learned. J Epidemiol Glob Health 2020;10(2):115. google scholar
• Republic of Turkey Ministry of Health (MoH-TR). COVID-19 information platform. 2023. Available from: https://covid19.saglik.gov.tr. google scholar
• Johns Hopkins University and Medicine. Coronavirus Resource Center Dashboard by the Center for Systems Science and Engineering. 2020. Available from: https://coronavirus.jhu.edu/map.html. google scholar
• World Health Organization. Turkey. 2023. Available from: https://www.who.int/ countries/tur. google scholar
• Cunning C, Hodes M. The COVID-19 pandemic and obsessive-compulsive disorder in Young people: Systematic review. Clin Child PsYchol Psychiatry 2022;27(1):18-34. google scholar
• Tanir Y, Karayagmurlu A, Kaya I, Kaynar TB, Türkmen G, Dambasan BN, et al. Exacerbation of obsessive-compulsive disorder symptoms in children and adolescents during COVID-19 pandemic. Psychiatry Res 2020;293:113363. google scholar
• Visnjic-Jevtic A, Paz-Albo J, Sahin-Sak İT, Varga NagY A, Sânchez-Perez N, Ozturk G, et al. Policies and practices of early childhood education and care during the COVID-19 pandemic: Perspectives from five countries. J Child Educ Soc 2021;2(2):200-16. google scholar
• White MD, Fradella HF. Policing a pandemic: Stay-at-home orders and what they mean for the police. Am J Crim Justice 2020;45:702-17. google scholar
• Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psYchological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020;395(10227):912-20. google scholar
• Oxford ARC StudY. Achieving resilience during COVID-19 weeklY report 2. Mental Health Res Matters 2020. Available from: http://mentalhealthres earchmatters.org.uk/achieving-resilience-during-covid-19-psYcho-social-risk-protective-factors-amidst-a-pandemic-in-adolescents/. google scholar
• Cam HH, Ustuner-Top F, Kuzlu-AYYildiz T. Impact of the COVID-19 pandemic on mental health and health-related qualitY of life among universitY students in TurkeY. Curr PsYchol 2022;41(2):1033-42. google scholar
• Chen B, Sun J, Feng Y. How have COVID-19 isolation policies affected Young people’s mental health? Front PsYchol 2020;11:1529. google scholar
• Durak-Batigun A, Senkal-Erturk I. COVID-19 associated psychological symptoms in Turkish population: A path model. Curr Psychol 2023;42(3):2436-47. google scholar
• Ozdin S, BaYrak-Ozdin S. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Pychiatry 2020;66(5):504-11. google scholar
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: American PsYchiatric Association; 2013. google scholar
• Mataix-Cols D, Rauch SL, Baer L, Eisen JL, Shera DM, Goodman WK, et al. SYmptom stabilityin adult obsessive-compulsive disorder: Data from a naturalistic two-Year follow-up study. Am J Psychiatry 2002;159(2):263-8. google scholar
• Ball SG, Baer L, Otto MW. SYmptom subtYpes of obsessive-compulsive disorder in behavioral treatment studies: A quantitative review. Behav Res Ther 1996;34(1):47-51. google scholar
• Davide P, Andrea P, Martina O, Andrea E, Davide D, Mario A. The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination sYmptoms and remission state before the quarantine in a preliminarY naturalistic studY. PsYchiatrY Res 2020;291:113213. google scholar
• Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect 2008;136(7):997-1007. google scholar
• Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National ComorbiditY SurveY Replication. Mol PsYchiatrY 2010;15(1):53-63. google scholar
• Coskun M, Zoroglu S, Ozturk M. Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder. Child Adolesc Psychiatry Ment Health 2012;6:1-9. google scholar
• Darvishi E, Golestan S, Demehri F, Jamalnia S. A cross-sectional study on cognitive errors and obsessive-compulsive disorders among young people during the outbreak of coronavirus disease 2019. Activ Nerv Super 2020;62:137-42. google scholar
• Busner J, Targum SD. The Clinical Global Impressions Scale: Applying a Research Tool in Clinical Practice. Psychiatry (Edgemont). 2007;4:28-37. google scholar
• Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK, et al. Children's Yale-Brown Obsessive Compulsive Scale: Reliability and validity. J Am Acad Child Adolesc Psychiatry 1997;36(6):844-52. google scholar
• Storch EA, Merlo LJ, Larson MJ, Murphy TK, Goodman WK, Geffken GR, et al. Psychometric evaluation of the Children's Yale-Brown Obsessive-Compulsive Scale. Psychiatry Res 2004;128(2):163-73. google scholar
• Yucelen AG, Rodopman-Arman A, Topcuoglu V, Yazgan MY, Fisek G. Interrater reliability and clinical efficacy of the Children’s Yale-Brown Obsessive-Compulsive Scale in an outpatient setting. Compr Psychiatry 2006;47(1):48-53. google scholar
• Spielberger CD. State-Trait Anxiety Inventory: Bibliography. 2nd ed. Palo Alto, CA: Consulting Psychologists Press; 1989. google scholar
• Oner N, LeCompte MD. Manual of state trait anxiety inventory. Boğaziçi University Print House, 1998. google scholar