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.
    Full-text · Article · Oct 2014 · Anales de Psicología
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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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    ABSTRACT: Due to its complexity, in combination with a lack of scientific reports, fur-chewing became one of the most challenging behavioral problems common to captive chinchillas. In the last years, the hypothesis that fur-chewing is an abnormal repetitive behavior and that stress plays a role in its development and performance has arisen. Here, we investigated whether a relationship existed between the expression and intensity of fur-chewing behavior, elevated urinary cortisol excretion and anxiety-related behaviors. Specifically, we evaluated the following parameters in behaviorally normal and fur-chewing animals of both sexes: (1) mean concentrations of urinary cortisol metabolites and (2) anxiety-like behavior in an elevated plus-maze test. Urinary cortisol metabolites were higher only in females that expressed the most severe form of the fur-chewing behavior (P≤0.05). Likewise, only fur-chewing females exhibited increased (P≤0.05) anxiety-like behaviors associated with the elevated plus-maze test. Overall, these data provided additional evidence to support the concept that fur-chewing is a manifestation of physiological stress in chinchilla, and that a female sex bias exists in the development of this abnormal behavior.
    Full-text · Article · Apr 2012 · Hormones and Behavior
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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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    ABSTRACT: In the human menstrual cycle, luteal phase immunomodulation prevents the maternal immune system from attacking the half-foreign blastocyst should conception occur, thereby facilitating implantation and development. However, tolerance of the conceptus comes at the cost of increased vulnerability to infection. The compensatory behavioral prophylaxis hypothesis (Fessler, 2001; Fessler & Navarrete, 2003) holds that evolved psychological mechanisms enhance avoidance of potential contaminants during periods of reproductive immunomodulation so as to decrease the likelihood of infection. Because such immunomodulation is triggered by progesterone, this hormone is predicted to correspondingly enhance behavioral prophylaxis and the motivational states underlying it. We investigated specific domains of disease avoidance psychology in a nonclinical sample of women (n=120) by measuring salivary progesterone in naturally cycling women. We find that progesterone correlates directly with the degree to which women report emotions, thoughts, and behaviors consonant with enhanced prophylaxis.
    Full-text · Article · Feb 2011 · Hormones and Behavior
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