To synthesize the extant literature on the prevalence, phenomenology, etiology and treatment of postpartum obsessive-compulsive disorder (OCD). A discussion of differential diagnosis between postpartum OCD and other postpartum psychiatric conditions (e.g., depression, psychosis) and nonpostpartum-onset OCD is provided. DATA SOURCES, STUDY SELECTION AND DATA EXTRACTION: All studies addressing postpartum OCD between the years 1950 and 2011 were reviewed. Data from all pertinent studies was explored as it related to postpartum OCD.
Studies were organized based on their empirical technique (e.g., retrospective, prospective), population studied (e.g., clinical OCD, nonclinical populations, males), and etiological or treatment theory (e.g., cognitive-behavioral).
The prevalence, phenomenology, etiology, and treatment of postpartum OCD are reviewed. The limited data on treatment approaches and outcomes for postpartum OCD are highlighted with a discussion of the role of nurses in the prevention and identification of postpartum OCD.
"Finally, in the treatment of this psychopathology, the use of cognitive behavioural psychotherapy stands out as a first-line intervention , particularly in the framework of selective primary pre- vention. With regard to limitations observed, firstly there are remarkable methodological deficiencies that condition the generalization and validity of the epidemiological findings, that is: (1) reduced sample sizes, (2) heterogeneity in the kind of population selected (gynaecological samples versus OCD), (3) discrepancies in intervals assessed during pregnancy and/or puerperium, (4) no examination of possible concomitant depressive symptoms (differential diagnosis), and (5) use of retrospective designs (Speisman et al., 2011). With the aim of optimizing these deficiencies, it would be advisable to carry out prospective studies with gynaecological samples, which were assessed from the beginning of pregnancy and up to 6 months after delivery. "
[Show abstract][Hide abstract] ABSTRACT: The aim of this review is to describe the main theoretical find-ings and research conclusions about obsessive-compulsive disorder (OCD) in the perinatal period. On one hand, epidemiological studies show that the risk of OCD onset and/or exacerbation could increase in this period, par-ticularly in the puerperium. Phenomenologically, in this stage aggressive and contamination obsessions are very common and are related to the fe-tus or newborn. On the other hand, regarding OCD pathogenesis in this period, there is indirect evidence to suggest the participation of neuroendo-crine (e.g. female gonadal steroids and oxytocin) and cognitive behavioural variables (e.g. hyper-responsibility, threat overestimation, and mental con-trol). In terms of research, more empirical studies are needed to contrast these specific vulnerability factors. Moreover, no empirically validated psy-chotherapeutic treatments (controlled trials) adapted to this OCD sub-group were found, although some studies highlight the role of cognitive behavioural therapy (CBT) as an effective intervention in the context of se-lective primary prevention.
Anales de Psicología 10/2014; 31(1). DOI:10.6018/analesps.31.1.168511 · 0.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: INTRODUÇÃO: O caráter familial do transtorno obsessivo-compulsivo (TOC) já é bem estabelecido. Ele segue o modelo complexo de transmissão genética que envolve a influência de diversos genes de pequeno efeito em interação com o ambiente. MÉTODOS: Foi realizada uma revisão sistemática de estudos de associação genética com o TOC por meio de busca de artigos publicados até 2012 nas bases de dados: PubMed, Embase e SciELO, usando os termos MeSH, seus associados ou sinônimos para "obsessive-compulsive disorder", "gene" e "genetic association studies". RESULTADOS: Foram selecionados 105 artigos cujos principais resultados foram agrupados em grupos de genes relacionados a serotonina, dopamina, glutamato, GABA, substância branca, hormônios, sistema imune e outros genes (MAO-A, BNDF, COMT). CONCLUSÃO: Há grande variabilidade nos achados de estudos de associação entre os diversos genes candidatos estudados e o TOC. Genes relacionados às vias glutamatérgicas são candidatos promissores, porém não há associação conclusiva entre nenhum dos genes candidatos estudados e o TOC. Estudos de associação com grande tamanho amostral, avaliação de subgrupos mais homogêneos do fenótipo e metanálises ainda são necessários.
Revista de Psiquiatria Clínica 12/2012; 40(5):177-190. DOI:10.1590/S0101-60832013000500003 · 0.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Parenting behaviors and parent-infant emotional bonding during the early postpartum months play a critical role in infant development. However, the nature and progression of parental thoughts and their relationship with interactive behaviors have received less research. The current study investigated the trajectory of parental thoughts and behaviors among primiparous mothers (n = 18) and fathers (n = 15) and multiparous mothers (n = 13) and fathers (n = 13), which were measured at the first and third postpartum month. At the third postpartum month, the relationship between parental thoughts and parental interactive behaviors also was tested. Mothers and fathers showed high levels of preoccupations and caregiving thoughts during the first postpartum month that significantly declined by the third postpartum month. In contrast, positive thoughts about parenting and the infant increased over the same time interval. Mothers presented higher levels of preoccupations and positive thoughts than did fathers, and first-time parents reported more intense preoccupations than did experienced parents. Although maternal sensitivity was inversely related to maternal anxious thoughts, paternal sensitivity was predicted by higher levels of anxious as well as caregiving and positive thoughts.
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