Abstract
Fear to contamination is an easy-to-provoke, intense, hard-to-control, and extraordinarily persistent fear. A worsening of preexisting psychiatric disorders was observed during the COVID-19 (coronavirus disease 2019) outbreak, and several studies suggest that those with obsessive–compulsive disorder (OCD) may be more affected than any other group of people. In the face of worsening OCD symptoms, there is a need for mental health professionals to provide the support needed not only to treat patients who still report symptoms, but also to improve relapse prevention. In this line, it is recommended to improve alternative strategies such as online consultations and digital psychiatry. The aim of this study is to develop augmented reality (AR) stimuli that are clinically relevant for patients with cleaning OCD and assess their efficiency to obtain emotionally significant responses. Four AR stimuli were developed: a plastic bag full of garbage, a piece of bread with mold, a dirty sports shoe, and a piece of rotten meat. All stimuli were shown to a clinical group (17 patients with cleaning OCD) and a control group (11 patients without OCD). Relevant results were the design of the AR stimuli. These stimuli were validated with the statistical difference in perceived anxiety in the meat stimuli between the clinical and control groups. Nevertheless, when looking at effect sizes, all stimuli present effect sizes from small (plastic bag) to large (meat), with both shoe and bread between small and medium effect sizes. These results are a valuable support for the clinical use of these AR stimuli in the treatment of cleaning OCD.
Highlights
Fear to contamination is an easy-to-provoke, intense, hard-to-control, and extraordinarily persistent fear
A worsening of preexisting psychiatric disorders was observed during the coronavirus disease 2019 (COVID-19) outbreak (Yao et al, 2020), and several studies suggest that those with obsessive–compulsive disorder (OCD) may be more affected than any other group of people (Fineberg et al, 2020)
The results suggest that the outbreak of COVID-19 generated a worsening of symptoms in patients with symptoms of contamination and patients who had not reached a state of remission before quarantine
Summary
Fear to contamination is an easy-to-provoke, intense, hard-to-control, and extraordinarily persistent fear. It is a kind of fear that is often culturally prescribed, highly spread by the media, which makes it more expansive and contagious (Rachman, 2004; Durna et al, 2019) This fear has been identified as the most common symptom of the obsessive–compulsive disorder (OCD, Mathes et al, 2019). The general fear of infection and the emphasis on handwashing in health advertising lead to worsening OCD symptoms. In this line, Davide et al (2020) developed a study to assess changes in OCD symptoms during quarantine in OCD patients who had received psychiatric care. The results suggest that the outbreak of COVID-19 generated a worsening of symptoms in patients with symptoms of contamination (compared with patients with other symptoms of OCD) and patients who had not reached a state of remission before quarantine (compared with patients who still showed a state of remission before quarantine)
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