Postpartum Onset Obsessive-compulsive Disorder – an Overlooked Condition

Abstract

Introduction

Given the profound life changing event that having a child represents, women are at an increased risk of developing psychiatric illness during the postpartum period. Although postpartum depression and psychosis have been widely studied, postpartum onset obsessive compulsive-disorder (OCD) seems to be an overlooked condition, remaining many times undiagnosed and untreated.

Objectives/Aims

This work aims to review the prevalence, clinical features and characteristics of postpartum onset OCD.

Methods

A review of relevant literature was conducted alongside online database research (PubMed and Medscape).

Results

In postpartum onset OCD obsessions are typically related to the baby and include: fear of intentionally or accidentally harm the newborn, fear of contamination, obsessions of symmetry/exactness, aggression and religiousness. These intrusive and obsessional thoughts, especially aggressive obsessions, create great distress and fear on acting on them.

To relieve the anxiety common compulsions include: avoiding taking care of the baby, repetitive and ritualistic washing, checking, ordering, counting, reassurance seeking, and praying.

The lifetime prevalence of OCD in general population is about 2 – 3%, however the prevalence of postpartum onset OCD is not known.

Conclusions

Further investigation is necessary to clarify the epidemiology, risk factors, and clinical course of postpartum OCD. Is it crucial to reassure parents that these intrusive thoughts are frequent, and do not translate any unconscious desires.

These symptoms should be screened appropriately and identified in the early postpartum period, in order to reduce the associated distress, family dysfunction, and the negative impact in the mother-infant bonding.