International Journal of Behavioral Sciences

International Journal of Behavioral Sciences

Prevalence and Clinical Presentations of Postpartum Obsessive-Compulsive Disorder in Iranian Pregnant Women

Document Type : Original Article

Authors
Abbas Masoudzadeh 1
Hooman Faghih-Nasiri 1
Reza-ali Mohamadpour 2
Shahrbanoo Jafari 3
Yazdan Naderi-Rajeh 4
1 Department of Psychiatry, School of Medicine and Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
2 Department of Biostatistics, Mazandaran University of Medical Sciences
3 Mazandaran University of Medical Sciences
4 Department of clinical psychology, University of social welfare and rehabilitation sciences
10.30491/ijbs.2021.262639.1445
Abstract
Introduction: Pregnancy, childbirth, and maternity are correlated with the heightened risk of the evolvement of postpartum obsessive-compulsive symptoms. This study aimed to inquire about the prevalence rate, clinical presentations, and relevant factors of postpartum Obsessive-Compulsive Symptoms (OCS).
Method: This cross-sectional study evaluated OCD in the postpartum period of women referred to the Imam Hospital in Sari, Mazandaran province, Iran. The sample population included 359 pregnant women who delivered their babies during the first half of 2018. The samples were taken using the convenience sampling method. Patients who scored 12 or higher in the Maudsley Obsessive-Compulsive Inventory completed the Yale-Browne Obsessive-Compulsive Scale self-report, and the Life Event Checklist were included in the study. Finally, data were analyzed using IBM SPSS version 24.
Results: The 359 mothers were in the range of 14 to 35 years old. Accordingly, 62.1% (223) were urban women while 37.9% (136) were rural, 20.6% (74) had preterm infants, 56.8% (204) term infants, and 22.3% (80) were post-term. Maudsley’s test showed that 48.5% (174) of the mothers had a positive OCD result. The total scorein Yale-Brown was significant, and had a reverse correlation with the mother’s residency (t = -173, p = 0.02) and significant correlation with the age of a pregnancy (t = 269, p= 0.001(.
Conclusion: According to the results of the Maudsley test, women are at risk of OCD during the postpartum period. Actually, OCD affects the mother-baby relation, mother’s anxiety, and depression and should be addressed during womens’ postpartum clinical care.
Keywords
Clinical Presentations
Obsessive-Compulsive Disorder
Postpartum
Prevalence
  1. Hodgson RJ, Rachman S. Obsessional-compulsive complaints. Behaviour research and therapy. 1977;15(5):389-95.
  2. House SJ, Tripathi SP, Knight BT, Morris N, Newport DJ, Stowe ZN. Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome. Archives of ’ ’women’s mental health. 2016;19(1):3-10.
  3. Russell EJ, Fawcett JM, Mazmanian D. Risk of obsessive-compulsive disorder in pregnant and postpartum women: a meta-analysis. The Journal of clinical psychiatry. 2013;74(4):377-85.
  4. Ali E. Women’s experiences with postpartum anxiety disorders: a narrative literature review. International journal of ’ ’women’s health. 2018;10:237.
  5. Miller ES, Hoxha D, Wisner KL, Gossett DR. Obsessions and compulsions in postpartum women without obsessive compulsive disorder. Journal of ’ ’Women’s Health. 2015;24(10):825-30.
  6. Wenzel A, Haugen E, Jackson L, Robinson K. Prevalence of generalized anxiety at eight weeks postpartum. Archives of ’ ’women’s mental health. 2003;6(1):43-9.
  7. Zambaldi CF, Cantilino A, Montenegro AC, Paes JA, de Albuquerque TLC, Sougey EB. Postpartum obsessive-compulsive disorder: prevalence and clinical characteristics. Comprehensive psychiatry. 2009;50(6):503-9.
  8. Jaisoorya T, Reddy YJ, Srinath S. Is juvenile obsessive-compulsive disorder a developmental subtype of the disorder? European child & adolescent psychiatry. 2003;12(6):290-7.
  9. Maina G, Albert U, Bogetto F, Vaschetto P, Ravizza L. Recent life events and obsessive–compulsive disorder (OCD): the role of pregnancy/delivery. Psychiatry Research. 1999;89(1):49-58.
  10. Speisman BB, Storch EA, Abramowitz JS. Postpartum obsessive‐compulsive disorder. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2011;40(6):680-90.
  11. Arnold LM. A case series of women with postpartum-onset obsessive-compulsive disorder. Primary care companion to the Journal of clinical psychiatry. 1999;1(4):103.
  12. McGuinness M, Blissett J, Jones C. OCD in the perinatal period: is postpartum OCD (ppOCD) a distinct subtype? A review of the literature. Behavioural and cognitive psychotherapy. 2011;39(3):285-310.
  13. Labad J, Alonso P, Segalas C, Real E, Jimenez S, Bueno B, et al. Distinct correlates of hoarding and cleaning symptom dimensions in relation to onset of obsessive–compulsive disorder at menarche or the perinatal period. Archives of ’ ’women’s mental health. 2010;13(1):75-81.
  14. Uguz F, Ayhan MG. Epidemiology and clinical features of obsessive-compulsive disorder during pregnancy and postpartum period: a review. Psychiatry and Behavioral Sciences. 2011;1(4):178.
  15. Neziroglu F, Anemone R, Yaryura-Tobias JA. Onset of obsessive-compulsive disorder in pregnancy. The American journal of psychiatry. 1992;149(7):947-50.
  16. Kalra H, Tandon R, kumar Trivedi J, Janca A. Pregnancy-induced obsessive compulsive disorder: a case report. Annals of General Psychiatry. 2005;4(1):12.
  17. Namouz-Haddad S, Nulman I. Safety of treatment of obsessive compulsive disorder in pregnancy and puerperium. Canadian Family Physician. 2014;60(2):133-6.
  18. Edwards LJ. Postpartum Obsessive-Compulsive Disorder and Depression: Faces of Helpless Caregiving: Mills College; 2019.
  19. Miller ES, Chu C, Gollan J, Gossett DR. Obsessive-Compulsive symptoms during the postpartum period. The Journal of reproductive medicine. 2013;58(3-4):115.
  20. Sternberger LG, Burns GL. Maudsley obsessional-compulsive inventory: obsessions and compulsions in a non-clinical sample. Behaviour Research and Therapy. 1990;28(4):337-40.
  21. Ghassemzadeh H, Khamseh A, Ebrahimkhani N. Demographic variables and clinical features of obsessivecompulsive disorder in Iranian patients. Obsessive-Compulsive Disorder Research. New York: Nova Science Publishers, Inc; 2005.
  22. Holmes TH, Rahe RH. The social readjustment rating scale. Journal of psychosomatic research. 1967.
  23. Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, et al. The yale-brown obsessive compulsive scale: II. Validity. Archives of general psychiatry. 1989;46(11):1012-6.
  24. Norbeck JS. Modification of life event questionnaires for use with female respondents. Research in Nursing & Health. 1984;7(1):61-71.
  25. VAFAEI B. Evaluation of the relation between life stresses and blood neoplastic diseases in males and females aged between 30 and 50. 2000.
  26. Massoudzadeh A. A survey of Obsessive-Compulsive Disorder prevalence among High school girl students in Sari. Journal of Mazandaran University of Medical Sciences. 2007;17(60):95-101.
  27. Rajab Dizavandi F, Salar Haji A, Kordi M, Vaghei N, Vaghee S. Comparing the Severity of Obsessive-Compulsive Symptoms in Pre-pregnancy, Pregnancy, and Postpartum Period among Women of reproductive age. Journal of Midwifery and Reproductive Health. 2019;7(3):1806-14.
  28. Faisal-Cury A, Menezes P, Araya R, Zugaib M. Common mental disorders during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil. Archives of ’ ’women’s mental health. 2009;12(5):335.
  29. Sichel DA, Cohen LS, Dimmock JA, Rosenbaum JF. Postpartum obsessive compulsive disorder: a case series. The Journal of clinical psychiatry. 1993.
  30. Sheikhmoonesi F, Hajheidari Z, Masoudzadeh A, Mohammadpour RA, Mozaffari M. Prevalence and severity of obsessive-compulsive disorder and their relationships with dermatological diseases. Acta Medica Iranica. 2014:511-4.
  31. Forray A, Focseneanu M, Pittman B, McDougle CJ, Epperson CN. Onset and exacerbation of obsessive-compulsive disorder in pregnancy and the postpartum period. The Journal of clinical psychiatry. 2010;71(8):1061.

 

 

International Journal of Behavioral Sciences
Volume 15, Issue 2
Summer 2021
Pages 138-143