Obsessive-compulsive symptoms in pregnancy and the puerperium:: A review of the literature
Section snippets
Prevalence
Three early studies on factors associated with onset of OCD identified subgroups of patients whose symptoms began during or immediately following pregnancy. In one investigation, Pollitt (1957) reviewed histories of 150 patients with OCD (63 males and 87 females) and found that 93 of these individuals (62%) believed a specific event precipitated onset of their symptoms. For 10 patients (11%) the significant event was pregnancy or childbirth. Ingram (1961) conducted a similar study of 89
Etiological theories
To date, the literature has largely endorsed a biological etiology of postpartum OCD. Guided by the well-known “serotonin hypothesis” (Barr, Goodman, & Price, 1993), authors have generally implicated a dysregulation of the serotonin system in the generation of obsessional thoughts and compulsive behavior. In particular, there is some evidence to suggest that fluctuations in estrogen and progesterone levels (as observed in late pregnancy) may alter serotonergic transmission, reuptake, and
Treatment
Research over the last 30 years suggests that two forms of treatment are effective for OCD: (a) pharmacotherapy by serotonin reuptake inhibitor medication (SRIs), and (b) cognitive-behavioral psychotherapy using the procedures of exposure and response prevention (Abramowitz, 1997). SRI pharmacotherapy, the most widely used therapy for OCD, typically results in a 20–40% reduction in symptoms. Two studies on postpartum OCD described use of this treatment. Buttolph and Holland (1990), in their
Future directions
To date, only a small number of retrospective studies have focused on the interesting phenomenon of puerperal OCD. Although it appears that some women (and perhaps their partners) experience a rapid onset of obsessive-compulsive symptoms during or immediately following pregnancy, the existing research cannot answer important questions related to the prevalence, course, or etiology of this problem. Because OCD poses a potential threat to parent and child well being, prospective investigations
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S-ketamine exerts sex- and dose-dependent anti-compulsive-like effect as monotherapy or in augmentation to fluoxetine
2022, European Journal of PharmacologyPeripartum complications associated with obsessive compulsive disorder exacerbation during pregnancy
2021, Journal of Obsessive-Compulsive and Related DisordersThe Prenatal Obsessive-Compulsive Scale: Psychometric and descriptive study in a Portuguese sample
2021, Journal of Obsessive-Compulsive and Related DisordersCitation Excerpt :Our results about OCS onset and comorbidity are in line with other studies that suggest that pregnancy may trigger or exacerbate OCS (Abramowitz et al., 2003; McGuinness et al., 2011), which are closely related to anxiety and depression during the same period (Collardeau et al., 2019; Speisman et al., 2011). Together with other studies (eg.: McGuinness et al., 2011; Abramowitz et al., 2003), our results raise the question of whether perinatal OCD represents a discrete subgroup of OCD. There is now growing acceptance that OCD is a clinically heterogeneous condition with wide variation in the specific content of obsessions and compulsions (Abramowitz, McKay, & Taylor, 2005; McGuinness et al., 2011).
Maternal wellbeing: an association between prenatal obsessive-compulsive disorder and antenatal care
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