Female Reproductive Cycle and Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder Clinical and Research Unit, Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 05/2005; 66(4):428-35; quiz 546. DOI: 10.4088/JCP.v66n0404
Source: PubMed


The aim of our study was to assess whether there is a relationship between reproductive cycle events and the initiation or changes in symptoms of obsessive-compulsive disorder (OCD).
Forty-six female outpatients meeting DSM-IV criteria for OCD completed a semistructured interview at our OCD unit to assess the relationship between reproductive cycle events and OCD. Dates of data collection were from January 2001 to December 2003.
In our sample, OCD onset occurred in the same year as menarche in 22% (N = 10), at pregnancy in 2% (N = 1), at postpartum in 7% (N = 3), and at menopause in 2% (N = 1). Worsening of preexisting OCD was reported by 20% of patients (9/45) at premenstruum, 8% (1/12) at pregnancy, 50% (6/12) at postpartum, and 8% (1/12) at menopause. The number of premenstrual mood symptoms, which included anxiety, irritability, mood lability and depressed mood, was associated with both premenstrual worsening of OCD (OR = 5.1, p < .01) and onset or worsening of OCD at postpartum (OR = 2.7, p < .05). Patients with an onset or worsening of OCD at postpartum also more frequently reported pre-menstrual worsening of OCD and previous history of major depressive disorder, including postpartum depression (p < or =.05 for all).
In a substantial number of patients, the onset or worsening of OCD was related to reproductive cycle events, especially at menarche and postpartum. Certain women with OCD seem to be vulnerable to worsening of OCD at different reproductive periods that imply hormonal fluctuations, and premenstruum and post-partum were the 2 reproductive events with a greater vulnerability. Those patients whose OCD symptoms appeared to be related to reproductive events also exhibited a greater history of mood symptoms (premenstrual depression and major depressive episodes).

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    • "Likewise, it is still not clear whether obstetric complications (additional stressful agent) have some modulating role on the levels of hyper-responsibility. So far, some studies have found a higher risk of having pOCD in women with obstetric complications (Maina et al., 1999; Zambaldi et al., 2009), whereas other research dismisses this option (Forray et al., 2010; Labad et al., 2005; Uguz et al., 2007a). On the other "
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    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
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    • "Author's personal copy patients, suggesting that ovarian hormones play a modulatory role in the course of those disorders (see reviews Albelda and Joel, 2012, in press). Indeed premenstrual, pregnancy and post-partum periods were associated with an increased risk of onset and exacerbation of OCD (Abramowitz et al., 2003; Labad et al., 2005; Vulink et al., 2006 "
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    Hormones and Behavior 04/2012; 61(5):758-62. DOI:10.1016/j.yhbeh.2012.03.017 · 4.63 Impact Factor
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    • "Likewise, we suggest that one of the major domains of OCD, contamination obsessions and washing compulsions, is an overexpression of attitudes and behaviors that have adaptively reduced the probability of infection. Indeed, consonant with the immunological consequences of female reproductive hormones, researchers have found that this facet of OCD is more frequently expressed by women (Bogetto et al., 1999; Castle et al., 1995), and that OCD onset is likely to follow reproductively relevant events such as menarche and pregnancy (Labad et al., 2005). OCD symptoms are exacerbated premenstrually (Vulink et al., 2006; Williams and Koran, 1997). "
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