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Obsessive-compulsive and related disorder symptoms in the perinatal period: prevalence and associations with
Michelle L Miller1,2, Anne I Roche3, Elizabeth Lemon4
1University of Iowa, Iowa City, USA. mlm41@iu.edu.
Insights
Obsessive-compulsive and related disorders (OCRD) symptoms, including body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD), are common during pregnancy and postpartum. These symptoms correlate with poorer postpartum functioning.
Area of Science:
- Psychiatry
- Perinatal Mental Health
- Clinical Psychology
Background:
- Obsessive-compulsive disorder (OCD) symptoms often emerge or worsen during pregnancy and the postpartum period.
- Obsessive-compulsive and related disorders (OCRD) have been understudied in the perinatal context.
- Existing research primarily focuses on OCD, neglecting other OCRDs like hoarding disorder (HD), body dysmorphic disorder (BDD), trichotillomania (TTM), and excoriation disorder (ED).
Purpose of the Study:
- To determine the prevalence of clinically significant OCRD symptoms during pregnancy and the postpartum period.
- To examine the relationship between OCRD psychopathology and postpartum functioning.
Main Methods:
- Prospective cohort study recruiting participants during the second trimester of pregnancy.
- Utilized online questionnaires and semi-structured clinical interviews.
- Assessed OCRD symptoms and postpartum functioning at two time points: pregnancy (28-32 weeks gestation) and postpartum (6-8 weeks).
Main Results:
- Body dysmorphic disorder (BDD) and OCD symptoms were the most prevalent OCRDs.
- During pregnancy, 14.9% reported significant BDD symptoms and 6.2% reported significant OCD symptoms.
- Postpartum, 11.8% reported significant BDD symptoms and 14% reported significant OCD symptoms.
- Elevated OCRD symptoms during pregnancy and postpartum were associated with poorer overall postpartum functioning.
Conclusions:
- OCRD symptoms, including BDD and OCD, manifest in the perinatal period at rates comparable to or exceeding other life stages.
- The presence of OCRD symptoms during pregnancy and postpartum is linked to diminished functioning in the postpartum period.
- Further research is needed to investigate the impact of all OCRD symptoms on perinatal functioning.
Abstract:
Obsessive-compulsive disorder (OCD) symptoms are more likely to develop or be exacerbated during pregnancy and the postpartum period, which can cause significant distress and impairment. However, the disorders grouped with OCD in the DSM-5, obsessive-compulsive and related disorders (OCRD; e.g., hoarding disorder (HD), body dysmorphic disorder (BDD), trichotillomania (TTM), excoriation disorder (ED)), have rarely been examined in the perinatal period. This study aimed to explore (1) the prevalence of all clinically significant OCRD symptoms in pregnancy and the postpartum period and (2) the correlations between OCRD psychopathology and postpartum functioning. Participants were recruited during their second trimester of pregnancy from a Midwestern medical center. Participants completed an online questionnaire and a semi-structured clinical interview during pregnancy (28-32 weeks' gestation, N = 276) and the postpartum period (6-8 weeks, N = 221). BDD and OCD symptoms were the most prevalent. In pregnancy, 14.9% (N = 41) of participants endorsed clinically significant BDD symptoms and 6.2% (N = 17) endorsed clinically significant OCD symptoms. In the postpartum period, 11.8% (N = 26) endorsed clinically significant BDD symptoms and 14% (N = 31) endorsed clinically significant OCD symptoms. Poorer postpartum functioning was associated with elevated OCRD symptoms in pregnancy and postpartum. OCRD symptoms occur during pregnancy and the postpartum period at rates similar or higher than other life periods. Elevated OCRD symptoms are associated with poorer postpartum functioning across domains. Future research should explore how all OCRD symptoms may affect functioning in the perinatal period, not only OCD symptoms.
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