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Onset and Exacerbation of Obsessive-Compulsive Disorder in Pregnancy and the Postpartum Period
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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.
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“As traumatic experiences, life transitions, and pregnancy or birth complications are considered risk factors for developing OCD [54, 55], more research is warranted to clarify the association between SB and OCD.”
From Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review (2021) · cites this paper as [55]
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Metadata
- Authors
- Forray, A., Focseneanu, M., Pittman, B., McDougle, C. J., & Epperson, C. N.
- Affiliations
- Yale University (US)
- Weill Cornell Medical Center (US)
- Indiana University School of Medicine (US)
- Corresponding author
- Forray, Ariadna
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2010-05-18
- Volume
- 71
- Issue
- 08
- Pages
- 1061-1068
- ISSN
- 0160-6689 (ISSN-L)
- PMC
- PMC4204467
- OpenAlex
- W2041383329
- Cited by
- 155
- References
- 36
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 9 · 2021: 17 · 2020: 15 · 2019: 13 · 2018: 10 · 2017: 9 · 2016: 11 · 2015: 13 · 2014: 7 · 2013: 8 · 2012: 7
- FWCI
- 9.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- Eli Lilly and Company
- National Institutes of Health
- National Institute of Mental Health (T32 MH18268, K02MH073090, T32MH018268)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, pregnancy, postpartum period, symptom exacerbation, childbirth, menstruation, reproductive events, women
- MeSH terms
- Acute Disease, Adolescent, Adult, Aged, Female, Humans, Male, Menarche, Middle Aged, Obsessive-Compulsive Disorder, Pregnancy, Pregnancy Complications, Premenstrual Syndrome, Psychiatric Status Rating Scales, Puerperal Disorders, Retrospective Studies, Severity of Illness Index, Comorbidity, Reproductive History, Age of Onset, Parturition, Diagnostic and Statistical Manual of Mental Disorders
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