Skip to main content
Erschienen in: Archives of Women's Mental Health 6/2010

01.12.2010 | Original Article

Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms

verfasst von: Jonathan S. Abramowitz, Samantha Meltzer-Brody, Jane Leserman, Susan Killenberg, Katherine Rinaldi, Brittain L. Mahaffey, Cort Pedersen

Erschienen in: Archives of Women's Mental Health | Ausgabe 6/2010

Einloggen, um Zugang zu erhalten

Abstract

Postpartum psychiatric disorders are widely recognized by clinicians and researchers, yet while much attention has been paid to perinatal mood disorders, considerably less has been given to anxiety and obsessive–compulsive symptoms in this population. The present study examined anxiety and obsessive–compulsive symptoms among postpartum women with mood complaints, with the aim of delineating the relationship between these symptoms. Sixty postpartum women seeking treatment in a perinatal mood disorders clinic completed measures of depression, anxiety, and obsessive–compulsive symptoms. Obsession-like thoughts and compulsive-like (“neutralizing”) strategies were present among the majority of the sample, yet the severity of these symptoms ranged widely. Depressive and anxiety symptoms were associated with obsessive and neutralizing compulsive symptoms. It may be helpful to consider anxiety and depressive symptoms as part of a broad spectrum of perinatal psychiatric illness. Clinicians should assess for anxiety and obsessive–compulsive symptoms as routinely as they assess for depressive symptoms in the perinatal period.
Literatur
Zurück zum Zitat Abramowitz JS, Schwartz SA, Moore KM (2003) Obsessional thoughts in postpartum females and their partners: content, severity and relationship with depression. J Clin Psychol Med Settings 10:157–164CrossRef Abramowitz JS, Schwartz SA, Moore KM (2003) Obsessional thoughts in postpartum females and their partners: content, severity and relationship with depression. J Clin Psychol Med Settings 10:157–164CrossRef
Zurück zum Zitat Abramowitz JS, Kandker M et al (2006a) The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: a prospective study. Behav Res Ther 9:1361–1374CrossRef Abramowitz JS, Kandker M et al (2006a) The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: a prospective study. Behav Res Ther 9:1361–1374CrossRef
Zurück zum Zitat Abramowitz JS, Larsen K, Moore KM (2006b) Treatment of anxiety disorders in pregnancy and the postpartum. In: Hendrick V (ed) Psychiatric disorders in pregnancy and the postpartum: principles and treatment. Humana Press, Totowa, NJ, pp 85–108 Abramowitz JS, Larsen K, Moore KM (2006b) Treatment of anxiety disorders in pregnancy and the postpartum. In: Hendrick V (ed) Psychiatric disorders in pregnancy and the postpartum: principles and treatment. Humana Press, Totowa, NJ, pp 85–108
Zurück zum Zitat Abramowitz JS, Nelson CA et al (2007) The cognitive mediation of obsessive–compulsive symptoms: a longitudinal study. J Anxiety Disord 21:91–104CrossRefPubMed Abramowitz JS, Nelson CA et al (2007) The cognitive mediation of obsessive–compulsive symptoms: a longitudinal study. J Anxiety Disord 21:91–104CrossRefPubMed
Zurück zum Zitat American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edition, text revision). Author, Washington DC American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edition, text revision). Author, Washington DC
Zurück zum Zitat Barlow DH (2002) Anxiety and its disorders. Guilford, New York Barlow DH (2002) Anxiety and its disorders. Guilford, New York
Zurück zum Zitat Bernstein IH, Rush AJ et al (2008) Symptom features of postpartum depression: are they distinct? Depress Anxiety 25:20–26CrossRefPubMed Bernstein IH, Rush AJ et al (2008) Symptom features of postpartum depression: are they distinct? Depress Anxiety 25:20–26CrossRefPubMed
Zurück zum Zitat Brandes M, Soares CN et al (2004) Postpartum onset of obsessive compulsive disorder: diagnosis and management. Arch Womens Ment Health 7:99–110CrossRefPubMed Brandes M, Soares CN et al (2004) Postpartum onset of obsessive compulsive disorder: diagnosis and management. Arch Womens Ment Health 7:99–110CrossRefPubMed
Zurück zum Zitat Britton JR (2007) Postpartum anxiety and breastfeeding. J Reprod Med 52:689–695PubMed Britton JR (2007) Postpartum anxiety and breastfeeding. J Reprod Med 52:689–695PubMed
Zurück zum Zitat Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh Postnatal Depression Scale measure anxiety? J Psychosom Res 5:659–663CrossRef Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh Postnatal Depression Scale measure anxiety? J Psychosom Res 5:659–663CrossRef
Zurück zum Zitat Cohen LS, Altshuler LL (2006) Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA 295:499–507CrossRefPubMed Cohen LS, Altshuler LL (2006) Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA 295:499–507CrossRefPubMed
Zurück zum Zitat Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786CrossRefPubMed Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786CrossRefPubMed
Zurück zum Zitat Fairbrother N, Abramowitz JS (2007) New parenthood a risk factor for the development of obsessional problems. Behav Res Ther 45:2155–2163CrossRefPubMed Fairbrother N, Abramowitz JS (2007) New parenthood a risk factor for the development of obsessional problems. Behav Res Ther 45:2155–2163CrossRefPubMed
Zurück zum Zitat Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (sum) 119:1–8 Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (sum) 119:1–8
Zurück zum Zitat Goodman WK, Price LH, Rasmussen SA et al (1989) The Yale–Brown Obsessive Compulsive Scale: validity. Arch Gen Psychiatry 46:1012–1016PubMed Goodman WK, Price LH, Rasmussen SA et al (1989) The Yale–Brown Obsessive Compulsive Scale: validity. Arch Gen Psychiatry 46:1012–1016PubMed
Zurück zum Zitat Jennings KD, Ross S et al (1999) Thoughts of harming infants in depressed and nondepressed mothers. J Affect Disord 54:21–28CrossRefPubMed Jennings KD, Ross S et al (1999) Thoughts of harming infants in depressed and nondepressed mothers. J Affect Disord 54:21–28CrossRefPubMed
Zurück zum Zitat Labad J, Menchon JM, Alonso P, Segalas C, Jiminez S, Vallejo J (2005) Female reproductive cycle and obsessive-compulsive disorder. J Clin Psychiatry 66(4):428–435 Labad J, Menchon JM, Alonso P, Segalas C, Jiminez S, Vallejo J (2005) Female reproductive cycle and obsessive-compulsive disorder. J Clin Psychiatry 66(4):428–435
Zurück zum Zitat Leckman JF, Goodman WK, North WG, Chapell PB, Price LH, Pauls DL, Andersen GM, Riddle MA, McSwiggan-Hardin M, Mcdougle CJ, Barr LC, Cohen DJ (1994) Elevated cerebrospinal fluid levels of oxytocin in obsessive-compulsive disorder. Arch Gen Psychiatry 51:782–793 Leckman JF, Goodman WK, North WG, Chapell PB, Price LH, Pauls DL, Andersen GM, Riddle MA, McSwiggan-Hardin M, Mcdougle CJ, Barr LC, Cohen DJ (1994) Elevated cerebrospinal fluid levels of oxytocin in obsessive-compulsive disorder. Arch Gen Psychiatry 51:782–793
Zurück zum Zitat Lee AM, Lam SK et al (2007) Prevalence, course and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112PubMed Lee AM, Lam SK et al (2007) Prevalence, course and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112PubMed
Zurück zum Zitat Maina G, Umberto A, Bogetto F, Vaschetto P, Ravizza L (1999) Recent life events and obsessive–compulsive disorder: the role of pregnancy/delivery. Psychiatry Res 89:49–58 Maina G, Umberto A, Bogetto F, Vaschetto P, Ravizza L (1999) Recent life events and obsessive–compulsive disorder: the role of pregnancy/delivery. Psychiatry Res 89:49–58
Zurück zum Zitat Martin A, Rief W, Klaiberg A, Braehler E (2006) Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. Gen Hosp Psych 28:71–77CrossRef Martin A, Rief W, Klaiberg A, Braehler E (2006) Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. Gen Hosp Psych 28:71–77CrossRef
Zurück zum Zitat Nunacs R, Cohen LS (1998) Postpartum mood disorders: diagnosis and treatment guidelines. J Clin Psychiatry 59(suppl 2):34–40 Nunacs R, Cohen LS (1998) Postpartum mood disorders: diagnosis and treatment guidelines. J Clin Psychiatry 59(suppl 2):34–40
Zurück zum Zitat Obsessive Compulsive Cognitions Working Group (1997) Cognitive assessment of obsessive–compulsive disorder. Behav Res Ther 35:667–681CrossRef Obsessive Compulsive Cognitions Working Group (1997) Cognitive assessment of obsessive–compulsive disorder. Behav Res Ther 35:667–681CrossRef
Zurück zum Zitat Perkin MR, Bland JM et al (1993) The effect of anxiety and depression during pregnancy on obstetrical complications. Br J Obstet Gynaecol 100:629–34PubMed Perkin MR, Bland JM et al (1993) The effect of anxiety and depression during pregnancy on obstetrical complications. Br J Obstet Gynaecol 100:629–34PubMed
Zurück zum Zitat Rambelli C, Montagnani MS et al (2010) Panic disorder as a risk factor for post-partum depression: results from the perinatal depression-research and screening unit study. J Affect Disord 122(1–2):139–143CrossRefPubMed Rambelli C, Montagnani MS et al (2010) Panic disorder as a risk factor for post-partum depression: results from the perinatal depression-research and screening unit study. J Affect Disord 122(1–2):139–143CrossRefPubMed
Zurück zum Zitat Salkovskis P, Shafran R et al (1999) Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research. Behav Res Ther 37:1055–1072CrossRefPubMed Salkovskis P, Shafran R et al (1999) Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research. Behav Res Ther 37:1055–1072CrossRefPubMed
Zurück zum Zitat Sichel DA, Cohen LS et al (1993) Postpartum obsessive compulsive disorder: a case series. J Clin Psychiatry 54:156–159PubMed Sichel DA, Cohen LS et al (1993) Postpartum obsessive compulsive disorder: a case series. J Clin Psychiatry 54:156–159PubMed
Zurück zum Zitat Spielberger CD (1970) Manual for the State–Trait Anxiety Inventory (self-evaluation questionnaire). Consulting Psychologists Press, California Spielberger CD (1970) Manual for the State–Trait Anxiety Inventory (self-evaluation questionnaire). Consulting Psychologists Press, California
Zurück zum Zitat Stein D, Hollander E (eds) (2002) Textbook of anxiety disorders (2nd ed). American Psychiatric Publishing, Inc., Washington DC Stein D, Hollander E (eds) (2002) Textbook of anxiety disorders (2nd ed). American Psychiatric Publishing, Inc., Washington DC
Zurück zum Zitat Steketee G, Frost RO, Bogert K (1995) The Yale–Brown Obsessive Compulsive Scale: interview versus self-report. Behav Res Ther 34:675–684CrossRef Steketee G, Frost RO, Bogert K (1995) The Yale–Brown Obsessive Compulsive Scale: interview versus self-report. Behav Res Ther 34:675–684CrossRef
Zurück zum Zitat Uguz F, Akman C, Kaya N, Cilli AS (2007) Postpartum-onset obsessive–compulsive disorder: incidence, clinical features, and related factors. J Clin Psychiatry 68:132–140CrossRefPubMed Uguz F, Akman C, Kaya N, Cilli AS (2007) Postpartum-onset obsessive–compulsive disorder: incidence, clinical features, and related factors. J Clin Psychiatry 68:132–140CrossRefPubMed
Zurück zum Zitat Viguera AC, Whitfield T et al (2007) Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry 164:1817–1824CrossRefPubMed Viguera AC, Whitfield T et al (2007) Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry 164:1817–1824CrossRefPubMed
Zurück zum Zitat Vulink NC, Denys D, Bus L, Westenberg HG (2006) Female hormones affect symptom severity in obsessive-compulsive disorder. Int J Cloth Sci Technol 21(3):171–175 Vulink NC, Denys D, Bus L, Westenberg HG (2006) Female hormones affect symptom severity in obsessive-compulsive disorder. Int J Cloth Sci Technol 21(3):171–175
Zurück zum Zitat Wadwa PD, Sandman CA et al (1993) The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol 169:858–64 Wadwa PD, Sandman CA et al (1993) The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol 169:858–64
Zurück zum Zitat Weinberg M, Tronick EZ (1998) The impact of maternal psychiatric illness on infant development. J Clin. Psychiatry 59(suppl 2):53–61 Weinberg M, Tronick EZ (1998) The impact of maternal psychiatric illness on infant development. J Clin. Psychiatry 59(suppl 2):53–61
Zurück zum Zitat Wenzlaff RM (2005) Seeing solace and finding despair: the persistence of intrusive thoughts in depression. In: Clark DA (ed) Intrusive thoughts in clinical disorders. Guilford, New York, pp 54–85 Wenzlaff RM (2005) Seeing solace and finding despair: the persistence of intrusive thoughts in depression. In: Clark DA (ed) Intrusive thoughts in clinical disorders. Guilford, New York, pp 54–85
Zurück zum Zitat Williams K, Koran LM (1997) Obsessive-compulsive disorder in pregnancy, the puerperium, and premenstruum. J Clin Psychiatry 7:330–334 Williams K, Koran LM (1997) Obsessive-compulsive disorder in pregnancy, the puerperium, and premenstruum. J Clin Psychiatry 7:330–334
Zurück zum Zitat Zambaldi CF, Cantilino A et al (2009) Postpartum obsessive–compulsive disorder: prevalence and clinical characteristics. Compr Psychiatry 50:503–509CrossRefPubMed Zambaldi CF, Cantilino A et al (2009) Postpartum obsessive–compulsive disorder: prevalence and clinical characteristics. Compr Psychiatry 50:503–509CrossRefPubMed
Metadaten
Titel
Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms
verfasst von
Jonathan S. Abramowitz
Samantha Meltzer-Brody
Jane Leserman
Susan Killenberg
Katherine Rinaldi
Brittain L. Mahaffey
Cort Pedersen
Publikationsdatum
01.12.2010
Verlag
Springer Vienna
Erschienen in
Archives of Women's Mental Health / Ausgabe 6/2010
Print ISSN: 1434-1816
Elektronische ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-010-0172-4

Weitere Artikel der Ausgabe 6/2010

Archives of Women's Mental Health 6/2010 Zur Ausgabe