Elsevier

Comprehensive Psychiatry

Volume 48, Issue 5, September–October 2007, Pages 441-445
Comprehensive Psychiatry

Obsessive-compulsive disorder in pregnant women during the third trimester of pregnancy

https://doi.org/10.1016/j.comppsych.2007.05.001Get rights and content

Abstract

Objective

The principal aims of this study were to examine the current prevalence rate, clinical characteristics, and related factors of obsessive-compulsive disorder (OCD) in pregnant women during the third trimester of pregnancy.

Method

The study data were gathered from 434 consecutive women in the third trimester of pregnancy who presented to the obstetric outpatient clinics of 2 university research centers and from 58 consecutive nonpregnant women with diagnosed with OCD who presented to the psychiatric outpatient clinics of the same centers. Obsessive-compulsive disorder was diagnosed by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The Yale-Brown Obsessive-Compulsive Scale was used to determine the severity and types of obsessions and compulsions.

Results

The prevalence rate of OCD was found to be 3.5% among the women in the third trimester of pregnancy. Two (0.5%) women reported that OCD developed during the second trimester (16th and 24th gestational weeks) of pregnancy. The most common obsessions were contamination (80.0%) and symmetry/exactness (60.0%), whereas the most common compulsions were cleaning/washing (86.7%) and checking (60.0%). Women with pregnancy-onset OCD and some women with previous diagnoses of OCD had obsessions and compulsions with themes focused on the fetus or newborn. Pregnant women with OCD had higher frequencies of family history of OCD compared with women without this disorder. Age, educational level, employment status, number of gestations and live births, history of abortion, frequency of primigravida, and the existence of gestational complications were unrelated to OCD in the pregnant women. Pregnant and nonpregnant women with OCD had similar characteristics of obsessive-compulsive symptoms.

Conclusion

Our study suggests that OCD is present relatively frequently among pregnant women during the third trimester of pregnancy, and it has similar clinical features during gestation and nongestation.

Introduction

Pregnancy is a period of the reproductive cycle in which physiologically marked alterations affecting neurotransmitter functions occur in gonadal steroids [1]. It is also one of the most important social and psychological life events for women. During this period, preexisting mood disorders may exhibit symptomatic exacerbation in some women [2]. Moreover, studies suggest that symptoms of depression and anxiety during pregnancy are predictive of a higher likelihood of postnatal depression [3], [4], [5].

The mean age of onset of obsessive-compulsive disorder (OCD) includes the childbearing years in women [6], and OCD is associated with evident impairment in the level of quality of life and disability in occupational and social areas [7], [8]. Some authors reported an association between pregnancy and onset of OCD in some women [9], [10]. Whereas Neziroglu et al [9] found a correlation between pregnancy and onset of OCD symptoms in 39% of female patients with OCD who have children, Labad et al [11] found this rate to be 6%. In addition, Williams and Koran [12] reported that pregnancy is associated with the onset of OCD in 13% of female patients with OCD who had been pregnant. Researches have also demonstrated that some pregnant women may have an increased risk of exacerbation of OCD symptoms [12], [13].

Although the relationship of OCD to pregnancy has been extensively explored, data regarding the prevalence and clinical characteristics of OCD during pregnancy are inadequate. Moreover, to the best of our knowledge, there is no study comparing symptomatology of OCD in pregnant and nonpregnant women. Therefore, this study principally aimed to examine the current prevalence, clinical features, and related factors of OCD during pregnancy. We additionally sought to examine the differences between the clinical features of OCD in pregnant women and nonpregnant women and to examine the course of preexisting OCD during pregnancy. Because of the last objective of this study, we planned on conducting the study among pregnant women during the third trimester of pregnancy.

Section snippets

Method

The study was conducted in 2 medical research centers: The Meram Medical School of Selçuk University in Konya, Turkey, and The Medical School of Kocatepe University in Afyon, Turkey. The study included 566 consecutive pregnant women who presented to the obstetric outpatient clinics of 2 research centers during the third trimester (27 or more gestational weeks) between January 2006 and May 2006 and were subsequently referred to the psychiatric outpatient clinics of the centers after their

Results

The mean age of the pregnant women (n = 434) was 27.23 ± 5.55 years (range, 17-44 years). All subjects were married, and most (n = 374; 86.2%) were housewives. The mean duration of pregnancy was 35.08 ± 3.77 weeks (range, 27-42 weeks); the mean number of pregnancies was 2.26 ± 1.32 (range, 1-8). The number of primigravida women was 154 (35.5%); 249 (57.4%) women had at least 1 live birth (Table 1).

Of 434 women, 15 (3.5%) met the criteria for OCD according to SCID-I during the third trimester of

Discussion

In the present study, the current prevalence of OCD was 3.5% in pregnant women during the third trimester of pregnancy. Twelve-month prevalence rates of OCD for women have been reported to be 0.37% to 3.3% in the general population [19], [20], [21], [22]. Whereas our prevalence rate was similar with that reported by Çilli et al [20], in 1 of the centers where the present study was carried out, it was higher than that reported in other communities (0.37%-1.8%). The prevalence rate we calculated

References (26)

  • H. Kalra et al.

    Pregnancy-induced obsessive-compulsive disorder: a case report

    Ann Gen Psychiatry

    (2005)
  • J. Labad et al.

    Female reproductive cycle and obsessive-compulsive disorder

    J Clin Psychiatry

    (2005)
  • K.E. Williams et al.

    Obsessive-compulsive disorder in pregnancy, the puerperium, and the premenstruum

    J Clin Psychiatry

    (1997)
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