Journal of Obstetric, Gynecologic & Neonatal Nursing
In ReviewPostpartum Obsessive‐Compulsive Disorder
Section snippets
Prevalence
Estimates of the prevalence of perinatal OCD vary widely. Anywhere from 25% to 70% of women with OCD report that pregnancy and/or childbirth was the precipitating life stressor in the development or significant worsening of their symptoms (Buttolph, [13]; Ingram, [27]; Pollitt, [42]). Reasons for the wide range in estimates include reliance on notoriously unreliable retrospective self reports, different types of study samples, and different definitions of obsessive‐compulsive symptoms.
Etiology
Several etiological theories have been proposed to explain the presence of obsessive‐compulsive symptoms in pregnancy and the postpartum including cognitive‐behavioral, biological, evolutionary/sociobiological, and psychosocial stressor theories. Theories of postpartum OCD should account for several postpartum specific features including rapid symptom onset, symptom content focused on harming the infant, and the emergence of obsessive‐compulsive symptoms in fathers (Abramowitz, Schwartz, Moore,
Phenomenology
The presentation of postpartum obsessive‐compulsive symptoms varies widely (Brockington et al., [12]). During pregnancy and the postpartum period, women's obsessions often concern fears of intentionally or accidentally causing harm to the baby (Buttolph, [13]; Labad et al., [31]; Ross & McLean, [45]). Other obsessional themes experienced in postpartum OCD have included contamination, symmetry/exactness (e.g., obsessing over the proper symmetrical positioning of the infant's blanket), aggression
Treatment
Treatment for postpartum OCD should involve similar approaches as used in treatment for OCD occurring at other times in life (for a review see Abramowitz, [2]), namely cognitive‐behavioral therapy (CBT) and serotonin reuptake inhibitor (SRI) medication. The primary treatment components of CBT involve helping the patient confront feared stimuli—including situations and thoughts (i.e., exposure)—while refraining from performing compensatory rituals (response prevention); this is referred to as
Implications and Future Directions
We highlight empirical and clinical findings on postpartum OCD. Although encouraging, there remain several areas within research and clinical work that warrant further consideration. First, prospective research is needed with clinical and nonclinical samples of women throughout their pregnancy and postpartum. Though informative, retrospective studies are limited by self‐report and recall bias, whereas case series highlight phenomenology but have limited generality and methodological rigor.
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Exploring the clinical features of postpartum obsessive-compulsive disorder- a systematic review
2024, European Journal of PsychiatryPerceived need of psychological support for taboo obsessions in new parents: A cross-sectional survey
2022, Journal of Obsessive-Compulsive and Related DisordersCitation Excerpt :Additionally, around 50% of new parents experience subthreshold levels of OCD (Abramowitz, Schwartz, & Moore, 2003; Brok et al., 2017; Fairbrother & Woody, 2008; Miller, Hoxha, Wisner, & Gossett, 2015). Several studies have indicated that taboo obsessions are the most common, and possibly the most distressing, OCD symptoms among new parents (Abramowitz et al., 2003; Abramowitz, Nelson, Rygwall, & Khandker, 2007; Brok et al., 2017; Hudepohl, MacLean, & Osborne, 2022; Speisman, Storch, & Abramowitz, 2011; Starcevic, Eslick, Viswasam, & Berle, 2020; Zambaldi et al., 2009). Taboo obsessions can be defined as distressing, ego-dystonic, sexual, religious and/or aggressive intrusive thoughts related to intentionally harming others (e.g., thoughts about stabbing the baby with a knife; Brakoulias et al., 2013).
Peripartum 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 :In this sample, the PASS (Pereira et al., 2019 b Cronbach alpha was of α = 0.95. The PDSS-24 and the PASS were used as criteria for PreOCS convergent validity because depressive, anxiety, and OCS commonly co-occur and may even convert into each other, particularly during the perinatal period (Collardeau et al., 2019; Speisman, Storch, & Abramowitz, 2011). SPSS 24.0 for Windows and AMOS 24.0 software were used.
Interventions for paternal perinatal depression: A systematic review
2020, Journal of Affective DisordersCitation Excerpt :PPD may be expressed through classical symptom criteria as defined in the DSM-V and ICD-10. There may also be higher rates of anger, substance use, low job satisfaction, and poor physical health (Epifanio et al., 2015; Speisman et al., 2011; Condon et al., 2004). Untreated PPD has been shown to negatively impact the entire family system including children's social and emotional development, behavior, and attachment (Field, 2010; Fletcher et al., 2011; Giallo et al., 2013; Hammarlund et al., 2015; Ramchandani et al., 2011; Rominov et al., 2016).
Postpartum obsessive-compulsive disorder
2019, Advanced Casebook of Obsessive-Compulsive and Related Disorders: Conceptualizations and Treatment