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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    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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    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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