The impact of the coronavirus (COVID-19) pandemic on the development of obsessive-compulsive symptoms in Saudi Arabia

Deemah A. Alateeq; Haneen N. Almughera; Tharaa N. Almughera; Raghad F. Alfedeah; Taeef S. Nasser; Khozama A. Alaraj

doi:10.15537/smj.2021.42.7.20210181

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Table 1

- Demographic and clinical characteristic of respondents (n=2909).

Demographic and clinical characteristic	Low stress (%)	Moderate stress (%)	High stress (%)	Frequency (%)	P-value
Age groups (years)					<0.001
18-29	17.90	57.90	24.20	1640 (56.4)
30-39	27.70	60.80	11.50	530 (18.2)
40-49	40.20	53.40	6.50	386 (13.3)
50-59	57.60	37.80	4.50	288 (9.9)
≥60	67.70	32.30	0.00	65 (2.2)
Gender					<0.001
Male	38.70	53.60	7.80	760 (26.1)
Female	23.80	55.90	20.30	2149 (73.9)
Nationality					0.163
Saudi	28.00	55.00	17.00	2787 (95.8)
Non-Saudi	20.50	61.50	18.00	122 (4.2)
Region of residence					<0.001
Central	28.80	56.50	14.70	1695 (58.3)
Western	25.40	53.10	21.60	552 (19.0)
Eastern	26.20	55.10	18.70	363 (12.5)
Southern	34.60	50.30	15.20	191 (6.6)
Northern	14.80	57.40	27.80	108 (3.7)
Level of education					0.224
Below high school level	26.80	61.00	12.20	41 (1.4)
High school level	25.90	54.10	20.00	486 (16.7)
University level or above	28.00	55.40	16.50	2382 (81.9)
Marital status					<0.001
Single	18.70	58.40	22.90	1627 (55.9)
Married	39.30	51.40	9.30	1159 (39.8)
Divorced/widow	37.40	50.40	12.20	123 (4.2)
Do you have children?					<0.001
Yes	39.60	51.60	8.90	1094 (37.6)
No	20.50	57.50	22.00	1815 (62.4)
Occupation					<0.001
Healthcare professional	28.50	56.00	15.50	193 (6.7)
Employed	35.00	55.50	9.40	965 (33.3)
Housewife	40.40	47.20	12.40	322 (11.1)
Unemployed	27.00	52.70	20.30	404 (13.9)
Student	16.90	58.20	24.90	1017 (35.1)
Housing status					<0.001
Own home	33.60	54.20	12.20	1183 (40.7)
Living with family	21.20	55.90	22.90	1137 (39.1)
Renting	28.20	55.60	16.20	532 (18.3)
Other	28.10	61.40	10.50	57 (2.0)
Are you disciplined with quarantine?					0.486
Always	28.30	54.50	17.20	2200 (75.6)
Often	25.50	57.60	16.90	674 (23.2)
Never	28.60	62.90	8.60	35 (1.2)
How many days spent in quarantine?					0.032
Less than 20 days	31.40	54.10	14.40	229 (7.9)
20-39 days	29.30	58.90	11.80	314 (10.8)
40-59 days	21.10	63.00	15.90	459 (15.8)
60 days and more	28.50	53.00	18.50	1907 (65.6)
Smoking					0.004
Smoker	33.90	52.20	13.90	360 (12.4)
Non-smoker	26.80	55.70	17.50	2549 (87.6)
Do you have any chronic disease?					0.005
Yes	34.50	49.90	15.60	423 (14.5)
No	26.50	56.20	17.30	2486 (85.5)
Are you diagnosed with any psychiatric disease?					<0.001
Yes	13.60	54.50	31.90	191 (6.6)
No	28.70	55.30	16.00	2718 (93.4)

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Table 2

- Responses to the perceived stress scale from participants (n=2909).

Perceived stress scale	Responses	n (%)
1. In the last month, how often have you been upset because of something that happened unexpectedly?	Never	763 (26.20)
	Almost never	586 (20.10)
	Sometimes	1004 (34.50)
	Fairly often	349 (12.00)
	Very often	207 (7.10)
2. In the last month, how often have you felt that you were unable to control the important things in your life?	Never	925 (31.80)
	Almost never	504 (17.30)
	Sometimes	782 (26.90)
	Fairly often	391 (13.40)
	Very often	307 (10.60)
3. In the last month, how often have you felt nervous and “stressed”?	Never	437 (15.00)
	Almost never	406 (14.00)
	Sometimes	878 (30.20)
	Fairly often	576 (19.80)
	Very often	612 (21.00)
4. In the last month, how often have you felt confident about your ability to handle your personal problems?	Never	559 (19.20)
	Almost never	861 (29.60)
	Sometimes	837 (28.80)
	Fairly often	414 (14.20)
	Very often	238 (8.20)
5. In the last month, how often have you felt that things were going your way?	Never	235 (8.10)
	Almost never	628 (21.60)
	Sometimes	1030 (35.40)
	Fairly often	513 (17.60)
	Very often	503 (17.30)
6. In the last month, how often have you found that you could not cope with all the things that you had to do?	Never	541 (18.60)
	Almost never	614 (21.10)
	Sometimes	1087 (37.40)
	Fairly often	411 (14.10)
	Very often	256 (8.80)
7. In the last month, how often have you been able to control irritations in your life?	Never	336 (11.60)
	Almost never	740 (25.40)
	Sometimes	980 (33.70)
	Fairly often	484 (16.60)
	Very often	369 (12.70)
8. In the last month, how often have you felt that you were on top of things?	Never	297 (10.20)
	Almost never	730 (25.10)
	Sometimes	964 (33.10)
	Fairly often	511 (17.60)
	Very often	407 (14.00)
9. In the last month, how often have you been angered because of things that were outside of your control?	Never	277 (9.50)
	Almost never	472 (16.20)
	Sometimes	1021 (35.10)
	Fairly often	641 (22.00)
	Very often	498 (17.10)
10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?	Never	697 (24.00)
	Almost never	689 (23.70)
	Sometimes	730 (25.10)
	Fairly often	430 (14.80)
	Very often	363 (12.50)

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Table 3

- Demographic characteristic of respondents with obsessive symptoms (dirt, germs, viruses).

Variables	Worried about dirt, germs, viruses.			P-value
Variables	Only during COVID-19 pandemic n (%)	Before and during COVID-19 pandemic n (%)	Never n (%)	P-value
Age groups (years)				<0.001
18-29	947 (57.7)	453 (27.6)	240 (14.6)
30-39	297 (56.0)	156 (29.4)	77 (14.5)
40-49	243 (63.0)	85 (22.0)	58 (15.0)
50-59	166 (57.60)	56 (19.4)	66 (22.9)
≥60	27 (41.5)	10 (15.4)	28 (43.1)
Gender				0.763
Male	458 (60.3)	155 (20.4)	147 (19.3)
Female	1222 (56.9)	605 (28.2)	322 (15.0)
Nationality				0.979
Saudi	1604 (57.6)	739 (26.5)	444 (15.9)
Non-Saudi	76 (62.3)	21 (17.2)	25 (20.5)
Region of residence				0.587
Central	1002 (59.1)	423 (25.0)	270 (15.9)
Western	315 (57.1)	144 (26.1)	93 (16.8)
Eastern	197 (54.3)	106 (29.2)	60 (16.5)
Southern	103 (53.9)	56 (29.3)	32 (16.8)
Northern	63 (58.3)	31 (28.7)	14 (13.0)
Level of education				0.390
Below high school level	24 (58.5)	8 (19.5)	9 (22.0)
High school level	272 (56.0)	125 (25.7)	89 (18.3)
University level or above	1384 (58.1)	627 (26.3)	371 (15.6)
Marital status				0.319
Married	684 (59.0)	283 (24.4)	192 (16.6)
Divorced /widow	68 (55.3)	26 (21.1)	29 (23.6)
Single	928 (57.0)	451 (27.7)	248 (15.2)
Do you have children?				0.556
Yes	649 (59.3)	263 (24.0)	182 (16.6)
No	1031 (56.8)	497 (27.4)	287 (15.8)
Occupation				0.047
Healthcare professional	103 (53.4)	57 (29.5)	33 (17.1)
Employed	582 (60.3)	208 (21.6)	175 (18.1)
Housewife	192 (59.6)	76 (23.6)	54 (16.8)
Unemployed	207 (51.2)	121 (30.0)	76 (18.8)
Student	592 (58.2)	294 (28.9)	131 (12.9)
Housing status				0.700
Own home	702 (59.3)	290 (24.5)	191 (16.1)
Living with family	638 (56.1)	323 (28.4)	176 (15.5)
Renting	310 (58.3)	131 (24.6)	91 (17.1)
Other	30 (52.6)	16 (28.1)	11 (19.3)
Are you disciplined with quarantine?				0.012
Always	1241 (56.4)	606 (27.5)	353 (16.0)
Sometimes	422 (62.6)	148 (22.0)	104 (15.4)
Never	17 (48.6)	6 (17.1)	12 (34.3)
How many days spent in quarantine?				0.015
Less than 20 days	120 (52.4)	51 (22.3)	58 (25.3)
20-39 days	184 (58.6)	90 (28.7)	40 (12.7)
40-59 days	257 (56.0)	129 (28.1)	73 (15.9)
60 days and more	1119 (58.7)	490 (25.7)	298 (15.6)
Smoking				0.607
Smoker	215 (59.7)	73 (20.3)	72 (20.0)
Non-smoker	1465 (57.5)	687 (27.0)	397 (15.6)
Do you have any chronic disease?				0.488
Yes	245 (57.9)	119 (28.1)	59 (13.9)
No	1435 (57.7)	641 (25.8)	410 (16.5)
Are you diagnosed with any psychiatric disease?				0.727
Yes	106 (55.5)	55 (28.8)	30 (15.7)
No	1574 (57.9)	705 (25.9)	439 (16.2)

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Table 4

- Demographic characteristic of respondents with compulsive symptoms (Repeated hand washing).

Variables	Wash hands very often or in a special way to be sure I am not dirty or contaminated.			P-value
Variables	Only during COVID-19 pandemic n (%)	Before and during COVID-19 pandemic n (%)	Never n (%)	P-value
Age groups (years)				0.005
18-29	747 (45.5)	238 (14.5)	655 (39.9)
30-39	265 (50.0)	63 (11.9)	202 (38.1)
40-49	182 (47.2)	54 (14.0)	150 (38.9)
50-59	120 (41.7)	41 (14.2)	127 (44.1)
≥60	20 (30.8)	5 (7.7)	40 (61.5)
Gender				0.279
Male	334 (43.9)	110 (14.5)	316 (41.6)
Female	1000 (46.5)	291 (13.5)	858 (39.9)
Nationality				0.865
Saudi	1280 (45.9)	382 (13.7)	1125 (40.4)
Non-Saudi	54 (44.3)	19 (15.6)	49 (40.2)
Region of residence				0.938
Central	791 (46.7)	217 (12.8)	687 (40.5)
Western	239 (43.3)	90 (16.3)	223 (40.4)
Eastern	170 (46.8)	51 (14.0)	142 (39.1)
Southern	86 (45.0)	26 (13.6)	79 (41.4)
Northern	48 (44.4)	17 (15.7)	43 (39.8)
Level of education				0.328
Below high school level	21 (51.2)	10 (24.4)	10 (24.4)
High school level	213 (43.8)	82 (16.9)	191 (39.3)
University level or above	1100 (46.2)	309 (13.0)	973 (40.8)
Marital status				0.227
Married	536 (46.2)	148 (12.8)	475 (41.0)
Divorced \ Widow	65 (52.8)	17 (13.8)	41 (33.3)
Single	733 (45.1)	236 (14.5)	658 (40.4)
Do you have children?				0.368
Yes	522 (47.7)	132 (12.1)	440 (40.2)
No	812 (44.7)	269 (14.8)	734 (40.4)
Occupation				0.122
Healthcare professional	89 (46.1)	26 (13.5)	78 (40.4)
Employed	480 (49.7)	109 (11.3)	376 (39.0)
Housewife	148 (46.0)	42 (13.0)	132 (41.0)
Unemployed	158 (39.1)	73 (18.1)	173 (42.8)
Student	456 (44.8)	150 (14.7)	411 (40.4)
Housing status				0.999
Own home	541 (45.7)	165 (13.9)	477 (40.3)
Living with family	525 (46.2)	151 (13.3)	461 (40.5)
Renting	241 (45.3)	79 (14.8)	212 (39.8)
Other	27 (47.4)	6 (10.5)	24 (42.1)
Are you disciplined with quarantine?				0.961
Always	999 (45.4)	317 (14.4)	884 (40.2)
Often	317 (47.0)	83 (12.3)	274 (40.7)
Never	18 (51.4)	1 (2.9)	16 (45.7)
How many days spent in quarantine?				0.084
Less than 20 days	93 (40.6)	22 (9.6)	114 (49.8)
20-39 days	148 (47.1)	43 (13.7)	123 (39.2)
40-59 days	220 (47.9)	60 (13.1)	179 (39.0)
60 days and more	873 (45.8)	276 (14.5)	758 (39.7)
Smoking				0.058
Smoker	181 (50.3)	49 (13.6)	130 (36.1)
Non-smoker	1153 (45.2)	352 (13.8)	1044 (41.0)
Do you have any chronic disease?				0.988
Yes	189 (44.7)	68 (16.1)	166 (39.2)
No	1145 (46.1)	333 (13.4)	1008 (40.5)
Are you diagnosed with any psychiatric disease?				0.443
Yes	81 (42.4)	30 (15.7)	80 (41.9)
No	1253 (46.1)	371 (13.6)	1094 (40.3)

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Table 5

- Chi-square test of association between obsessive-compulsive symptoms and perceived stress.

Variables	Perceived stress scale			Total
Variables	Low	Moderate	High	Total
I am worried about dirt, germs, and viruses
Only during COVID-19 Pandemic	453 (56.3)	942 (58.6)	285 (57.5)	1680 (57.8)
Before and During COVID-19 Pandemic	150 (18.6)	457 (28.4)	153 (30.8)	760 (26.1)
Never	202 (25.1)	209 (13.0)	58 (11.7)	469 (16.1)
I wash my hands very often or in a special way to be sure I am not dirty or contaminated
Only during COVID-19 Pandemic	301 (37.4)	778 (48.4)	255 (51.4)	1334 (45.9)
Before and During COVID-19 Pandemic	76 (9.4)	243 (15.1)	82 (16.5)	401 (13.8)
Never	428 (53.2)	587 (36.5)	159 (32.1)	1174 (40.4)
Total	805 (100.0)	1608 (100.0)	496 (100.0)	2909 (100.0)
P-value <0.001. Effect size (Phi) = 0.167