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Symptoms of Obsessive-Compulsive Disorder during Pregnancy and the Postpartum Period: a Systematic Review and Meta-Analysis

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Abstract

The main aim of this systematic review and meta-analysis was to calculate and compare the frequencies of obsessions and compulsions in women with obsessive-compulsive disorder (OCD) during pregnancy (OCD-P), the postpartum period (OCD-PP) and when they are neither pregnant nor postpartum (OCD-NPP). Fourteen studies were selected after applying the inclusion and exclusion criteria. The meta-analysis showed that aggressive obsessions were much more common in OCD-PP than in OCD-P and OCD-NPP and that washing/cleaning compulsions were less frequent in OCD-PP than in OCD-P and OCD-NPP. These differences were significant, whereas the frequencies of various obsessions and compulsions did not distinguish between OCD-P and OCD-NPP. Obsessions about accidental harm to the infant and other infant-focused obsessions, checking compulsions, self-reassurance and seeking reassurance from others were also relatively common in OCD-PP. Clinical manifestations of OCD-PP are relatively specific and differ from those of OCD-P and OCD-NPP, whereas OCD-P does not seem to have distinct clinical features. Although these findings do not necessarily suggest that OCD-PP is a distinct subtype of OCD, they have important conceptual and clinical implications.

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Funding

Preparation of this paper was supported by a National Health and Medical Research Council (NHRMC) Early Career Fellowship (GNT1122203) awarded to David Berle. The NHMRC had no role in the design of the study, data collection, data analysis, interpretation of data or in the writing or revision of the manuscript. Other authors did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors for this research.

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Authors and Affiliations

  1. Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, University of Sydney, Penrith, Sydney, NSW, Australia

    Vladan Starcevic & Kirupamani Viswasam

  2. Department of Psychiatry, Nepean Hospital, PO Box 63, Penrith, NSW, 2751, Australia

    Vladan Starcevic & Kirupamani Viswasam

  3. Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, The Whiteley-Martin Research Centre, Discipline of Surgery, University of Sydney, Penrith, NSW, Australia

    Guy D. Eslick

  4. Discipline of Clinical Psychology, University of Technology Sydney, Sydney, NSW, Australia

    David Berle

  5. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia

    David Berle

Authors
  1. Vladan Starcevic
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  2. Guy D. Eslick
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  3. Kirupamani Viswasam
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  4. David Berle
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Contributions

Vladan Starcevic conceptualized the study, performed literature search, wrote the first draft of the manuscript, revised it and prepared it for submission. Guy D. Eslick performed data analysis and participated in the preparation of the manuscript. Kirupamani Viswasam performed literature search and participated in the preparation of the manuscript. David Berle participated in the conceptualization of the study, literature search and preparation of the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Vladan Starcevic.

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Starcevic, V., Eslick, G.D., Viswasam, K. et al. Symptoms of Obsessive-Compulsive Disorder during Pregnancy and the Postpartum Period: a Systematic Review and Meta-Analysis. Psychiatr Q 91, 965–981 (2020). https://doi.org/10.1007/s11126-020-09769-8

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