Document Detail

Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period.
MedLine Citation:
PMID:  20492843     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The primary goal of this study was to examine the impact of pregnancy, childbirth, and menstruation on the onset of obsessive-compulsive disorder (OCD) and/or exacerbation of OCD symptoms.
METHOD: One hundred twenty-six women aged between 18 and 69 years attending a university-based OCD clinic who met DSM-IV criteria for OCD according to the Structured Clinical Interview for DSM-IV Disorders were interviewed retrospectively to assess OCD onset and symptom exacerbation in relationship to reproductive events. Women were placed into 2 groups: those who had ever been pregnant (ever pregnant group) and those who had never been pregnant. The ever pregnant group was further subdivided into those who reported onset of OCD in the perinatal period (perinatal-related group) and those who denied onset related to pregnancy (nonperinatal-related group). Between-group comparisons were done using a Student t test for continuous measures, and categorical variables were assessed using the χ² test.
RESULTS: Of the 78 women in the ever pregnant group, 32.1% (n = 24) had OCD onset in the perinatal period (perinatal-related group), 15.4% in pregnancy, 14.1% at postpartum, and 1.3% after miscarriage. Of 132 total pregnancies, 34.1% involved an exacerbation of symptoms, 22.0% involved an improvement in OCD symptoms, and 43.9% did not change symptom severity in women with preexisting illness. Women in the perinatal-related group and women with perinatal worsening of preexisting OCD were more likely to have premenstrual worsening of OCD symptoms compared to women in the nonperinatal-related group (66% vs 39%, P = .047).
CONCLUSIONS: Findings from this study provide additional evidence that pregnancy and childbirth are frequently associated with the onset of OCD or worsening of symptoms in those with preexisting disorder. In addition, there appears to be continuity between OCD onset and/or exacerbation across the reproductive life cycle, at least with menstruation and pregnancy.
Ariadna Forray; Mariel Focseneanu; Brian Pittman; Christopher J McDougle; C Neill Epperson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-18
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  71     ISSN:  1555-2101     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-09-09     Revised Date:  2014-10-22    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1061-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Physicians Postgraduate Press, Inc.
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MeSH Terms
Acute Disease
Age of Onset
Diagnostic and Statistical Manual of Mental Disorders
Menarche / physiology
Middle Aged
Obsessive-Compulsive Disorder / diagnosis*,  epidemiology
Parturition / physiology
Pregnancy Complications / diagnosis*,  epidemiology
Premenstrual Syndrome / diagnosis,  epidemiology
Psychiatric Status Rating Scales
Puerperal Disorders / diagnosis*,  epidemiology
Reproductive History*
Retrospective Studies
Severity of Illness Index
Grant Support
Comment In:
J Clin Psychiatry. 2011 Mar;72(3):417-8   [PMID:  21450163 ]

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