在新冠疫情期间美国人群样本中的与污染相关的行为、强迫观念和强迫行为。
Contamination-related behaviors, obsessions, and compulsions during the COVID-19 pandemic in a United States population sample.
机构信息
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21201, USA.
出版信息
J Psychiatr Res. 2021 Jun;138:155-162. doi: 10.1016/j.jpsychires.2021.03.064. Epub 2021 Apr 1.
BACKGROUND
Contamination-prevention behaviors such as mask wearing and physical distancing are crucial to reduce coronavirus transmission during the COVID-19 pandemic. We hypothesized that engagement in these behaviors could provoke obsessions and phobias in vulnerable individuals in the community.
METHODS
A total of 2117 participants, systematically selected to represent the age, gender, and race distributions of the US population, completed an online survey that assessed demographic characteristics, clinical features, COVID-19 risks, and COVID-19 contamination-prevention behaviors. Logistic regression was used to estimate the magnitude of the relationships between the COVID-19 behavior score and clinically significant contamination obsessions, contamination compulsions, and pre-COVID-19 to current change in obsessive-compulsive symptom scores.
RESULTS
The COVID-19 behavior score was significantly associated with contamination obsessions (odds ratio (OR) = 1.15, 95% CI = 1.12-1.16; p < 0.001) and contamination phobias (OR = 1.14, 95% CI = 1.12-1.16; p < 0.001). The COVID-19 behavior score also was associated with pre-pandemic to current increase in the overall obsessive-compulsive symptom score (OR = 1.16, 95% CI = 1.09-1.23; p < 0.001), as well as increase in obsessive-compulsive symptom score excluding washing items (OR = 1.13, 95% CI = 1.07-1.19; p < 0.001). The magnitude of these relationships did not appreciably change, after adjustment for other variables associated with the outcomes. Moreover, the relationship was significant in those with or without OCD, and in individuals with different levels of doubt and COVID-19 risk.
CONCLUSIONS
Contamination safety measures are critical for reducing the spread of COVID-19 in the community. However, they may be related to the development of contamination-related symptoms and OCD in vulnerable individuals, complicating the diagnosis and treatment of mental disorders during this period.
背景
在 COVID-19 大流行期间，戴口罩和保持身体距离等预防污染行为对于减少冠状病毒传播至关重要。我们假设，这些行为可能会引发社区中易受感染个体的痴迷和恐惧症。
方法
共有 2117 名参与者，系统地选择以代表美国人口的年龄、性别和种族分布，完成了一项在线调查，评估了人口统计学特征、临床特征、COVID-19 风险和 COVID-19 污染预防行为。使用逻辑回归估计 COVID-19 行为评分与临床显著污染痴迷、污染强迫和 COVID-19 前到当前强迫症症状评分变化之间的关系程度。
结果
COVID-19 行为评分与污染痴迷（优势比（OR）=1.15，95%置信区间（CI）=1.12-1.16；p<0.001）和污染恐惧症（OR=1.14，95%CI=1.12-1.16；p<0.001）显著相关。COVID-19 行为评分还与从大流行前到当前整体强迫症症状评分的增加相关（OR=1.16，95%CI=1.09-1.23；p<0.001），以及排除洗涤项目的强迫症症状评分增加（OR=1.13，95%CI=1.07-1.19；p<0.001）。在调整了与结果相关的其他变量后，这些关系的幅度并没有明显变化。此外，这种关系在有或没有强迫症的个体以及怀疑和 COVID-19 风险水平不同的个体中均具有统计学意义。
结论
污染安全措施对于减少社区中 COVID-19 的传播至关重要。然而，它们可能与易受感染个体中与污染相关的症状和强迫症的发展有关，这使得在此期间对精神障碍的诊断和治疗变得复杂。
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