Intensive cognitive-behavioural treatment for women with postnatal obsessive-compulsive disorder: a consecutive case
Fiona L Challacombe1, Paul M Salkovskis
1King's College London, Institute of Psychiatry, Department of Psychology, De Crespigny Park, London, UK. fiona.challacombe@kcl.ac.uk
Insights
Intensive cognitive-behaviour therapy (CBT) effectively treats postnatal obsessive-compulsive disorder (OCD) in mothers. Treatment improved maternal symptoms and parenting, with benefits sustained at follow-up.
Area of Science:
- Psychiatry
- Perinatal Mental Health
Background:
- Postnatal period is a high-risk time for obsessive-compulsive disorder (OCD) development.
- OCD symptoms may involve infant harm obsessions, impacting parenting capacities.
- Limited data exist on adapting cognitive-behaviour therapy (CBT) for postnatal OCD.
Observation:
- Six mothers with postnatal OCD received intensive, two-week CBT.
- Improvements were measured using self-report and clinician-rated scales.
- Symptom improvements were sustained at 3-5 month follow-up.
Findings:
- Intensive CBT significantly reduced postnatal OCD symptoms.
- Mothers reported enhanced parenting skills and well-being post-treatment.
- The intensive delivery model was effective and acceptable.
Implications:
- Intensive CBT is a viable treatment for postnatal OCD.
- Further research should investigate persistent parenting challenges.
- Understanding treatment impact on parenting is crucial for maternal and infant well-being.
Abstract:
The postnatal period has been identified as a time of increased risk for the development of OCD. Obsessions and compulsions at this time frequently focus on accidental or deliberate harm coming to the infant and may impact on the sufferer's capacities as a parent. Given the similarities in presentation between OCD at this and other times, cognitive-behaviour therapy is likely to be effective, but there is little information on whether or how adaptations of CBT can be made to maximise effectiveness and acceptability for mothers. There are no data on the impact of successful treatment on parenting. Six consecutively referred cases of postnatal OCD were treated using cognitive-behavioural therapy (CBT) intensively delivered over a two week period. All mothers improved on self-report and clinician-rated measures which were sustained at 3-5 month follow-up. Mothers reported significant benefits in terms of their own symptoms and in parenting in general. The intensive mode of delivery appears to be effective and acceptable for this group. Future work should explore whether particular difficulties in terms of parenting are experienced by this group and whether these persist beyond the remission of the maternal disorder.
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