Coping strategies in obsessive-compulsive patients during Covid-19 lockdown

  1. Ángel Rosa-Alcázar
  2. María Dolores García-Hernández
  3. José Luis Parada-Navas
  4. Pablo J. Olivares-Olivares
  5. Sergio Martínez-Murillo
  6. Ana I. Rosa-Alcázar
International journal of clinical and health psychology

ISSN: 1697-2600

Year of publication: 2021

Volume: 21

Issue: 2

Pages: 39-45

Type: Article

DOI: 10.1016/J.IJCHP.2021.100223 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: International journal of clinical and health psychology


The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.

Bibliographic References

  • American Psychiatric Association APA, 2013, Manual diagnóstico y estadístico de los trastornos mentales (DSM-5). Editorial Médica Panamericana, (2013)
  • Balasubramanian et al., 2020, Impact of COVID-19 on the mental health of surgeons and coping strategies. Head & Neck, 42 (2020), pp. 1638-1644
  • Banerjee, 2020, The COVID-19 outbreak: Crucial role the psychiatrists can play. Asian Journal of Psychiatry, 50 (2020),
  • Barrett et al., 2005, Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: Long-term follow-up and predictors of outcome. Journal American Academic Child Adolescent Psychiatry, 44 (2005), pp. 1005-1014
  • Benatti et al., 2020, What Happened to Patients With Obsessive Compulsive Disorder During the COVID-19 Pandemic? A Multicentre Report From Tertiary Clinics in Northern Italy. Frontiers in Psychiatry, 11 (2020),
  • Brailovskaia and Margraf, 2020, Predicting adaptive and maladaptive responses to the Coronavirus (COVID-19) outbreak: A prospective longitudinal study. International Journal of Clinical and Health Psychology, 20 (2020), pp. 183-191
  • Bueno-Notivol et al., 2021, Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. International Journal of Clinical and Health Psychology, 21 (2021),
  • Damirchi et al., 2020, The Role of Self-Talk in Predicting Death Anxiety, Obsessive-Compulsive Disorder, and Coping Strategies in the Face of Coronavirus Disease (COVID-19). Iranian Journal of Psychiatry, 15 (2020), pp. 182-188
  • Davide et al., 2020, 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 Research, 291 (2020),
  • Fineberg et al., 2020, How to manage obsessive-compulsive disorder (OCD) under COVID-19: A clinician’s guide from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) and the Obsessive-Compulsive Research Network (OCRN) of the European College of Neuropsychopharmacology. Comprehensive Psychiatry, 100 (2020),
  • Fiorillo and Gorwood, 2020, The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. European Psychiatry, 63 (2020), pp. 32
  • Fontenelle and Miguel, 2020, The impact of COVID‐19 in the diagnosis and treatment of obsessive-compulsive disorder. Depression and Anxiety, 37 (2020), pp. 510-511
  • Freeston and Ladouceur, 1997, What do patients do with their obsessive thoughts?. Behaviour Research and Therapy, 35 (1997), pp. 335-348
  • French and Lyne, 2020, Acute exacerbation of OCD symptoms precipitated by media reports of COVID-19. Irish Journal of Psychological Medicine, 21 (2020), pp. 1-4
  • Goodman et al., 1989, The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Archives of General Psychiatry, 46 (1989), pp. 1006-1011
  • Inchausti et al., 2020, La psicología clínica ante la pandemia COVID-19 en España. Clínica y Salud, 31 (2020), pp. 105-107
  • Kumar and Somani, 2020, Dealing with Corona virus anxiety and OCD. Asian Journal of Psychiatry, 51 (2020),
  • Ladouceur et al., 2000, Strategies used with intrusive thoughts: A comparison of OCD patients with anxious and community controls. Journal of Abnormal Psychology, 109 (2000), pp. 179-187
  • Lazarus, 2000, Toward better research on stress and coping. American Psychological Association, 55 (2000), pp. 665-673
  • Lazarus and Folkman, 1986, Estrés y procesos cognitivos. Martínez Roca, (1986),
  • Li et al., 2020, Progression of Mental Health Services during the COVID-19 Outbreak in China. International Journal Biological Sciences, 16 (2020), pp. 1732-1738
  • Matheson and Anisman, 2003, Systems of coping associated with dysphoria, anxiety and depressive illness: A multivariate profile perspective. Stress, 6 (2003), pp. 223-234
  • Mazza et al., 2020, A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors. International Journal of Environmental Research and Public Health, 17 (2020),
  • Monroe et al., 2007, Severe life events predict specific patterns of change in cognitive biases in major depression. Psychological Medicine, 37 (2007), pp. 863-871
  • Morán et al., 2010, COPE-28: un análisis psicométrico de la versión en español del Brief COPE. Universitas Psychologica, 9 (2010), pp. 543-552
  • Moritz et al., 2018, Obsessive-compulsive disorder is characterized by a lack of adaptive coping rather than an excess of maladaptive coping. Cognitive Therapy and Research, 42 (2018), pp. 650-660
  • Pfefferbaum and North, 2020, Mental health and the Covid-19 pandemic. New England Journal of Medicine, 383 (2020), pp. 510-512
  • Pozza et al., 2020, Risk for pathological contamination fears at coronavirus time: Proposal of early intervention and prevention strategies. Clinical Neuropsychiatry, 17 (2020), pp. 100-102
  • Ravindran et al., 2002, Stress, coping, uplifts, and quality of life in subtypes of depression: a conceptual model and emerging data. Journal Affective Disorders, 71 (2002), pp. 121-130
  • Rivera and Carballea, 2020, Coronavirus: A trigger for OCD and illness anxiety disorder?. Psychological Trauma: Theory, Research, Practice, and Policy, 12 (2020), pp. S66-S66
  • Rosa-Alcázar et al., 2020, Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder. International Journal of Clinical and Health Psychology, 20 (2020), pp. 20-28
  • Rosa-Alcázar et al., 2019, Family involvement and treatment for young children with Obsessive-Compulsive Disorder: Randomized control study. International Journal of Clinical and Health Psychology, 19 (2019), pp. 218-227
  • Seçer and Ulaş, 2020, An Investigation of the Effect of COVID-19 on OCD in Youth in the Context of Emotional Reactivity, Experiential Avoidance, Depression and Anxiety. International Journal of Mental Health and Addiction, 13 (2020), pp. 1-14
  • Silva et al., 2020, Obsessive-compulsive disorder during the COVID-19 pandemic. Brazilian Journal of Psychiatry, (2020),
  • Slavich, 2016, Life stress and health: A review of conceptual issues and recent findings. Teaching of Psychology, 43 (2016), pp. 346-355
  • Storch et al., 2010, The role of comorbid disruptive behavior in the clinical expression of pediatric obsessive-compulsive disorder. Behaviour Research and Therapy, 48 (2010), pp. 1204-1210
  • Wegner, 1989, White bears and other unwanted thoughts: Suppression, obsession, and the psychology of mental control. Penguin Press, (1989)
  • World Health Organization, 2020, Mental health and COVID-19. (2020)
  • Xiang et al., 2020, Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry, 7 (2020), pp. 228-229
  • Zigmond and Snaith, 1983, The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67 (1983), pp. 361-370