Symptoms of Obsessive-Compulsive Disorder during Pregnancy and the Postpartum Period: a Systematic Review and Meta-Analy
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Symptoms of Obsessive-Compulsive Disorder during Pregnancy and the Postpartum Period: a Systematic Review and Meta-Analysis Vladan Starcevic 1,2
3
& Guy D. Eslick & Kirupamani Viswasam
1,2
& David Berle
4,5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
The main aim of this systematic review and meta-analysis was to calculate and compare the frequencies of obsessions and compulsions in women with obsessive-compulsive disorder (OCD) during pregnancy (OCD-P), the postpartum period (OCD-PP) and when they are neither pregnant nor postpartum (OCD-NPP). Fourteen studies were selected after applying the inclusion and exclusion criteria. The meta-analysis showed that aggressive obsessions were much more common in OCD-PP than in OCD-P and OCD-NPP and that washing/cleaning compulsions were less frequent in OCD-PP than in OCD-P and OCD-NPP. These differences were significant, whereas the frequencies of various obsessions and compulsions did not distinguish between OCD-P and OCD-NPP. Obsessions about accidental harm to the infant and other infant-focused obsessions, checking compulsions, self-reassurance and seeking reassurance from others were also relatively common in OCD-PP. Clinical manifestations of OCD-PP are relatively specific and differ from those of OCD-P and OCD-NPP, whereas OCD-P does not seem to have distinct clinical features. Although these findings do not necessarily suggest that OCD-PP is a distinct subtype of OCD, they have important conceptual and clinical implications. Keywords Obsessive-compulsive disorder . Pregnancy . Postpartum . Systematic review . Metaanalysis Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11126-02009769-8) contains supplementary material, which is available to authorized users.
* Vladan Starcevic [email protected] Guy D. Eslick [email protected] Kirupamani Viswasam [email protected] David Berle [email protected] Extended author information available on the last page of the article
Psychiatric Quarterly
Introduction The perinatal period (i.e., the pregnancy and postpartum period) brings both hope and challenges to many women. A complex interplay of past experiences and current biological, psychological and social factors can leave women vulnerable to the onset or exacerbation of mental disorders during the perinatal period [1]. Examples include postnatal depression and the onset or worsening of bipolar disorder in the puerperium, which often manifests itself as puerperal psychosis. Obsessive-compulsive disorder (OCD) is not an exception in this regard. Studies suggest that the perinatal period is a risk factor for the onset or exacerbation of OCD, with pregnant and postpartum women being 1.5–2 times more likely to experience OCD compared to the general population [2]. This risk is higher in the postpartum period than during pregnancy. Consequently, the prevalence of OCD during pregnancy was found to range between 0.2% and 3.5% [3], while the prevalence of p
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