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Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period.
J Clin Psychiatry 2010; 71(8):1061-8JC

Abstract

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.

Authors+Show Affiliations

Departments of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. ariadna.forray@yale.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20492843

Citation

Forray, Ariadna, et al. "Onset and Exacerbation of Obsessive-compulsive Disorder in Pregnancy and the Postpartum Period." The Journal of Clinical Psychiatry, vol. 71, no. 8, 2010, pp. 1061-8.
Forray A, Focseneanu M, Pittman B, et al. Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period. J Clin Psychiatry. 2010;71(8):1061-8.
Forray, A., Focseneanu, M., Pittman, B., McDougle, C. J., & Epperson, C. N. (2010). Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period. The Journal of Clinical Psychiatry, 71(8), pp. 1061-8. doi:10.4088/JCP.09m05381blu.
Forray A, et al. Onset and Exacerbation of Obsessive-compulsive Disorder in Pregnancy and the Postpartum Period. J Clin Psychiatry. 2010;71(8):1061-8. PubMed PMID: 20492843.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period. AU - Forray,Ariadna, AU - Focseneanu,Mariel, AU - Pittman,Brian, AU - McDougle,Christopher J, AU - Epperson,C Neill, Y1 - 2010/05/18/ PY - 2009/05/07/received PY - 2009/09/28/accepted PY - 2010/5/25/entrez PY - 2010/5/25/pubmed PY - 2010/9/10/medline SP - 1061 EP - 8 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 71 IS - 8 N2 - 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. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/20492843/Onset_and_exacerbation_of_obsessive_compulsive_disorder_in_pregnancy_and_the_postpartum_period_ L2 - http://www.psychiatrist.com/jcp/article/pages/2010/v71n08/v71n0814.aspx DB - PRIME DP - Unbound Medicine ER -