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Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study.
Depress Anxiety 2014; 31(12):979-87DA

Abstract

BACKGROUND

Women with obsessive-compulsive disorder (OCD) often report that symptoms first appear or exacerbate during reproductive cycle events; however, little is known about these relationships. The goals of this study were to examine, in a US and a European female OCD sample, onset and exacerbation of OCD in reproductive cycle events, and to investigate the likelihood of repeat exacerbation in subsequent pregnancies and postpartum periods.

METHODS

Five hundred forty-two women (United States, n = 352; Dutch, n = 190) who met DSM-IV criteria for OCD, completed self-report questionnaires designed to assess OCD onset and symptom exacerbation associated with reproductive events.

RESULTS

OCD onset occurred within 12 months after menarche in 13.0%, during pregnancy in 5.1%, at postpartum in 4.7%, and at menopause in 3.7%. Worsening of pre-existing OCD was reported by 37.6% of women at premenstruum, 33.0% during pregnancy, 46.6% postpartum, and 32.7% at menopause. Exacerbation in first pregnancy was significantly associated with exacerbation in second pregnancy (OR = 10.82, 95% CI 4.48-26.16), as was exacerbation in first postpartum with exacerbation in second postpartum (OR = 6.86, 95% CI 3.27-14.36). Results were replicated in both samples.

CONCLUSIONS

Reproductive cycle events are periods of increased risk for onset and exacerbation of OCD in women. The present study is the first to provide significant evidence that exacerbation in or after first pregnancy is a substantial risk factor for exacerbation in or after a subsequent pregnancy. Further research is needed to identify factors related to exacerbation, so that physicians may provide appropriate recommendations to women regarding clinical issues involving OCD and reproductive cycle events.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24421066

Citation

Guglielmi, Valeria, et al. "Obsessive-compulsive Disorder and Female Reproductive Cycle Events: Results From the OCD and Reproduction Collaborative Study." Depression and Anxiety, vol. 31, no. 12, 2014, pp. 979-87.
Guglielmi V, Vulink NC, Denys D, et al. Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study. Depress Anxiety. 2014;31(12):979-87.
Guglielmi, V., Vulink, N. C., Denys, D., Wang, Y., Samuels, J. F., & Nestadt, G. (2014). Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study. Depression and Anxiety, 31(12), pp. 979-87. doi:10.1002/da.22234.
Guglielmi V, et al. Obsessive-compulsive Disorder and Female Reproductive Cycle Events: Results From the OCD and Reproduction Collaborative Study. Depress Anxiety. 2014;31(12):979-87. PubMed PMID: 24421066.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study. AU - Guglielmi,Valeria, AU - Vulink,Nienke C C, AU - Denys,Damiaan, AU - Wang,Ying, AU - Samuels,Jack F, AU - Nestadt,Gerald, Y1 - 2014/01/13/ PY - 2013/09/12/received PY - 2013/12/09/revised PY - 2013/12/11/accepted PY - 2014/1/15/entrez PY - 2014/1/15/pubmed PY - 2016/1/20/medline KW - female reproductive cycle events KW - obsessive-compulsive disorder KW - obstetrics-gynaecology KW - reproduction KW - women SP - 979 EP - 87 JF - Depression and anxiety JO - Depress Anxiety VL - 31 IS - 12 N2 - BACKGROUND: Women with obsessive-compulsive disorder (OCD) often report that symptoms first appear or exacerbate during reproductive cycle events; however, little is known about these relationships. The goals of this study were to examine, in a US and a European female OCD sample, onset and exacerbation of OCD in reproductive cycle events, and to investigate the likelihood of repeat exacerbation in subsequent pregnancies and postpartum periods. METHODS: Five hundred forty-two women (United States, n = 352; Dutch, n = 190) who met DSM-IV criteria for OCD, completed self-report questionnaires designed to assess OCD onset and symptom exacerbation associated with reproductive events. RESULTS: OCD onset occurred within 12 months after menarche in 13.0%, during pregnancy in 5.1%, at postpartum in 4.7%, and at menopause in 3.7%. Worsening of pre-existing OCD was reported by 37.6% of women at premenstruum, 33.0% during pregnancy, 46.6% postpartum, and 32.7% at menopause. Exacerbation in first pregnancy was significantly associated with exacerbation in second pregnancy (OR = 10.82, 95% CI 4.48-26.16), as was exacerbation in first postpartum with exacerbation in second postpartum (OR = 6.86, 95% CI 3.27-14.36). Results were replicated in both samples. CONCLUSIONS: Reproductive cycle events are periods of increased risk for onset and exacerbation of OCD in women. The present study is the first to provide significant evidence that exacerbation in or after first pregnancy is a substantial risk factor for exacerbation in or after a subsequent pregnancy. Further research is needed to identify factors related to exacerbation, so that physicians may provide appropriate recommendations to women regarding clinical issues involving OCD and reproductive cycle events. SN - 1520-6394 UR - https://www.unboundmedicine.com/medline/citation/24421066/Obsessive_compulsive_disorder_and_female_reproductive_cycle_events:_results_from_the_OCD_and_reproduction_collaborative_study_ L2 - https://doi.org/10.1002/da.22234 DB - PRIME DP - Unbound Medicine ER -