Although prior research estimated obsessive-compulsive disorder (OCD) affects about 2.2% of women over the pregnancy and postpartum period, a new study estimates that 17% of women met criteria for an OCD diagnosis in the 38 weeks after delivery, and 8% of women did during pregnancy. Researchers published their findings online in The Journal of Clinical Psychiatry.
“What really matters now is that we screen for and assess OCD among perinatal women with perinatal-specific questions and assessment methods,” said study lead author Nichole Fairbrother, PhD, a clinical associate professor at the University of British Columbia in Vancouver, Canada. “It is especially important that we include questions about intrusive thoughts of infant-related harm. This ensures that perinatal women suffering from OCD are not missed and can be directed toward appropriate treatment.”
The study included 580 women in British Columbia who completed online questionnaires and interviews, including a diagnostic interview to determine OCD status using Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria, during their third trimester of pregnancy and 9 months postpartum.
The prevalence of OCD gradually increased throughout pregnancy and early postpartum, the study showed. The peak prevalence, which was close to 9%, occurred 8 weeks after the baby’s birth. Afterward, the prevalence began to decline.
The use of more recent diagnostic criteria likely factored into the higher OCD rates found in the study, but researchers believe asking more specific questions about harm to the baby also played a role.
“The traditional questions are framed in a way that doesn’t really help women connect to the intrusive thoughts they’ve had about their baby,” said Dr. Fairbrother. “If they don’t recognize their experience in the questions that are asked, they may be underreporting.”
The study affirms perinatal OCD is a prevalent condition, researchers wrote.
“Perinatal OCD is common,” Dr. Fairbrother said, “and we have a responsibility to identify those who experience it and ensure they receive timely, evidence-based treatment.”
Fairbrother N, Collardeau F, Albert AYK, et al. High prevalence and incidence of obsessive-compulsive disorder among women across pregnancy and the postpartum. The Journal of Clinical Psychiatry. 2021;82(2):20m13398.