Obsessions and Compulsions in Women With Postpartum Depression

Women's Services, Mood Disorders Program, Case Western Reserve University, Cleveland, Ohio 44106, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 04/1999; 60(3):176-80. DOI: 10.4088/JCP.v60n0305
Source: PubMed


The quantity, content, and intensity of the obsessions and compulsions of women with postpartum onset major depressive disorder were compared with those of women with major depressive disorder with non-postpartum onset.
Sequential cases of women with postpartum onset major depression (N = 37) and major depression (N = 28) who presented to our Women's Mood Disorders program were included. Psychiatric examination using DSM-IV criteria and the Inventory to Diagnose Depression established the diagnosis of major depression. Obsessive thoughts and compulsions were reported on the Yale-Brown Obsessive Compulsive Scale and reviewed during the psychiatric examination. Comparisons between groups were performed with chi-square statistics, Fisher exact test and its extensions, and Mann-Whitney U test.
Although more women with postpartum onset major depression (N = 21, 57%) than major depression (N = 10, 36%) reported obsessional thoughts, the difference between the groups was not significant (p = .13). However, for women who endorsed obsessions, those with postpartum onset had a higher median number (median = 7) than women without postpartum onset (median = 2, p = .00). Most of the difference in frequency of thoughts was owing to more women with postpartum onset major depression having aggressive thoughts (N = 20, 95%) than women with major depression (N = 6, 60%, Fisher exact p = .03). The most frequent content of the aggressive thoughts for women with postpartum onset major depression was causing harm to their newborns or infants. The presence or number of obsessional thoughts or compulsions was not related to severity of the depressive episode.
Childbearing-aged women commonly experience obsessional thoughts or compulsions in the context of major depressive episodes. Women with postpartum onset major depression experience disturbing aggressive obsessional thoughts more frequently than women with non-postpartum major depression.

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    • "It is also used for obsessive-compulsive disorder (OCD), a prevalent disease of enhanced anxiety that has been diagnosed in around 2% of world population. Estrogen and progesterone imbalance and its influence on cerebrospinal fluid partly explain the incidence of psychological problems including OCD during pregnancy [2] [3]. Researchers have shown that OCD can be triggered during fertility periods like menstruation, pregnancy, or postparturition times. "
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    ABSTRACT: Objective. Depression during pregnancy is a relatively common problem. Since little is known about the teratogenic effects of concomitant administration of fluoxetine and olanzapine during the organogenesis period, the aim of the present study was to evaluate the teratogenic effects of coadministration of fluoxetine and olanzapine on rat fetuses. Method. Forty-two pregnant rats were divided into seven groups, randomly. The first group received 0.5 mL of normal saline as the control. The second and third groups received fluoxetine at doses of 9 mg/kg and 18 mg/kg, respectively. Olanzapine was injected at 3 mg/kg and 6 mg/kg to the fourth and fifth groups, respectively. The sixth group received 9 mg/kg fluoxetine and 3 mg/kg olanzapine. Finally, the seventh group was administrated with fluoxetine and olanzapine at 18 mg/kg and 6 mg/kg, respectively. Drugs were injected intraperitoneally between day eight and day 15 of the pregnancy. On the 17th day of pregnancy, the fetuses were removed and micro-/macroscopically studied. Results. Fetuses of rats receiving high doses of these drugs showed a significant rate of cleft palate development, premature eyelid opening and torsion anomalies, compared to the control group (P ≤ 0.01). It is concluded that these drugs can lead to teratogenicity, so their concomitant use during pregnancy should be avoided, or if necessary their doses must be decreased.
    Advances in Pharmacological Sciences 01/2014; 2014:132034. DOI:10.1155/2014/132034
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    • "Postpartum group: Higher irritability (purpose-designed checklist) Wisner et al. (1999) Postpartum women with major depression (n=37) and non-postpartum women with major depression (n=28) "
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    ABSTRACT: In perinatal mental health there is a lack of consensus as to whether postpartum emotional disorders are unique in their aetiology and clinical presentation. If the clinical presentation is unique, then the factor structure should be different in a postpartum sample. Admission and discharge scores on the Depression Anxiety Stress Scales (DASS; Lovibond and Lovibond, 1995b) scores were collected for 527 inpatients admitted to a Psychiatric Mother and Baby Unit. Reliability and validity of the DASS were examined, and confirmatory factor analysis evaluated the fit of a series of models of the DASS. The DASS had sound reliability and validity in the postpartum inpatient sample. The optimal fitting factor solution for the DASS was a revised three-factor model previously supported in studies of other clinical and non-clinical populations. The factor structure was invariant across admission and discharge. The sample consisted of postpartum inpatients and the generalisability of results to other postpartum samples is not known. Postpartum emotional symptoms have the same factor structure previously observed in non-postpartum populations, consistent with the hypothesis that postpartum emotional disorders are similar to those occurring at other times. The present study provides support for the reliability and validity of the DASS in the postpartum period.
    Journal of Affective Disorders 08/2013; 151(2). DOI:10.1016/j.jad.2013.08.002 · 3.38 Impact Factor
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    • "There is evidence suggesting the nature of symptoms differs little between depression within the postnatal period and depression experienced at any other time within the life cycle (Whiffen and Gotlib, 1993). However, studies highlight that mothers experiencing PPD report a greater frequency of aggressive thoughts towards their baby than depressed mothers with non-postpartum onset (Wisner et al., 1999). Crucially, PPD has been associated with negative outcomes for children whose mothers experience this depression, including poorer cognitive and emotional development, poor attachment and behavioural problems (Murray et al., 1996). "
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    ABSTRACT: OBJECTIVE: to examine perceptions of mothers experiencing postpartum depression utilising the revised Illness Perception Questionnaire (IPQ-R), to explore relationships between illness perceptions, depression severity and perceptions of maternal bonding, and to assess the psychometric properties within this population. DESIGN: longitudinal correlational design. SETTING: North West of England, UK. PARTICIPANTS: 43 mothers, who screened positive for postpartum depression (mean age 29.36 years) with babies whose mean age was 4 months. METHODS: participants were recruited through health services. Participants completed the IPQ-R and measures of depression severity and maternal bonding. Illness perceptions and depression severity were assessed at 2 time points, 4 weeks apart. FINDINGS: mothers endorsed IPQ-R subscales of cyclical timeline, consequences, emotional representations, treatment and personal control. IPQ-R subscale scores and depression severity correlated significantly at Time 1. Initial IPQ-R subscale scores, however, were not associated with and accounted for little variation in depression severity at Time 2. IPQ-R identity and consequence subscales positively correlated with perceived bonding difficulties. KEY CONCLUSIONS AND CLINICAL IMPLICATIONS: the IPQ-R was shown to be a reliable measure of illness perceptions in mothers experiencing postpartum depression. The maternal illness perceptions endorsed in this study have implications for clinical practice. Interventions aimed at developing a more coherent understanding of depression may enhance beliefs of personal control over symptoms, reduce the number of perceived symptoms and associated emotional distress. Educating mothers regarding the benefits of interventions may be important in increasing the number of mothers accessing support for postpartum depression.
    Midwifery 08/2012; 29(7). DOI:10.1016/j.midw.2012.06.020 · 1.57 Impact Factor
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