For the reason that launch of the Diagnostic and Statistical Handbook of Psychological Issues or DSM-V, Obsessive Compulsive Dysfunction (OCD) has been categorized underneath the umbrella time period of Obsessive Compulsive and associated problems (OCRD). This group of problems contains not solely OCD but additionally physique dysmorphic dysfunction (BDD), hoarding dysfunction (HD), trichotillomania (TTM), and excoriation dysfunction (ED).
Regardless of the continued debate that OCD could also be higher categorized underneath anxiousness problems, there are unmistakable and agreed upon similarities within the medical presentation, pathogenesis, genetic vulnerability, and therapy response between OCD and the opposite “associated problems.” Nonetheless, the remaining OCRDs haven’t been studied to the extent of OCD, even with the intense and well-established useful impairment related to these problems.
Charges of OCD are a stunning 7% to 11% throughout the perinatal interval with peak prevalence at about 8 weeks postpartum. Given the similarities that do exist between OCD and associated problems, and the recognized propensity for girls to expertise exacerbation of OCD throughout being pregnant and the postpartum interval, it stays a query as as to if ladies affected by different OC associated problems are at excessive threat of comparable impairment in functioning through the perinatal interval.
Being pregnant, whereas for a lot of ladies is a time of pleasure and nice anticipation, can also be a time of stress and transition, as there are huge modifications in life-style and in physique form, options and functioning. Stress has been linked to growth or exacerbation of all of the OCRDs, particularly the physique targeted OCRDs (ED, TMM, and BDD), it could not be stunning if the mixture of excessive stress and fast bodily modifications related to being pregnant might result in a rise in vulnerability to those body-focused OCRD signs when in comparison with different instances.
A current examine sought to look at the prevalence of all OCRDs in being pregnant and the postpartum interval, in addition to the ensuing useful impairment related to OCRD signs through the perinatal interval. Pregnant ladies have been recruited throughout their second trimester from a Midwestern medical heart and accomplished a web based questionnaire and a semi-structured medical interview between 28 and 32 weeks of gestation (N = 276) and through the postpartum interval (6-8 weeks, N = 221). OCRD signs have been assessed utilizing well-established, validated questionnaires.
The researchers noticed that in being pregnant, 14.9% (N = 41) of contributors endorsed clinically important BDD signs and 6.2% (N = 17) endorsed clinically important OCD signs. Throughout the postpartum interval, 11.8% (N = 26) endorsed clinically important BDD signs and 14% (N = 31) endorsed clinically important OCD signs. Trichotillomania and excoriation dysfunction signs additionally occurred (notably throughout being pregnant) however to a lesser extent. Worse postpartum functioning was noticed in ladies with elevated OCRD signs throughout being pregnant and the postpartum interval, with BDD signs having the best affect on functioning.
The researchers noticed not solely clinically important prevalence of BDD, HD, TTM, and ED throughout being pregnant and postpartum, but additionally a excessive stage of comorbid melancholy in these experiencing OCRD throughout being pregnant, particularly these with BDD and OCD. Even within the absence of depressive signs, elevated OCRD signs throughout being pregnant have been considerably related to total poorer postpartum adjustment, with the strongest affiliation between physique dysmorphic dysfunction signs and poorer postpartum adjustment.
The present examine is in line with earlier research exhibiting excessive charges of perinatal OCD signs and is the primary examine to evaluate the prevalence of OCRD on this inhabitants, demonstrating a very excessive prevalence of BDD signs in pregnant and postpartum ladies. On this examine, 14.9% of pregnant and 11.8% of postpartum ladies reported clinically important BDD signs, which is way increased than the estimated level prevalence of BDD (2.5%) noticed in grownup non-perinatal ladies. Noting this placing discovering, the authors speculated that BDD signs could also be thought of normative and maybe time-limited on condition that the transitions in physique picture related to being pregnant and the postpartum interval are a transient occasion.
One main limitation of this examine was that it didn’t consider the affect of societal pressures surrounding magnificence and physique picture throughout this main transition in a lady’s life. As such, it highlights the significance of normalizing such perinatal physique modifications which can be inconsistent with Western beliefs and inspecting this idea underneath the lens of a bigger public well being aim fairly than merely contemplating a lady’s perceptions of her physique as flawed and pathological. This uncovers a second limitation of the examine which is a failure to manage for pre-pregnancy physique dissatisfaction, preoccupation with weight, and disordered consuming behaviors.
Regardless of these limitations, it’s clear that OCD shouldn’t be the one dysfunction underneath the OCRD umbrella which can be exacerbated by being pregnant. On this context, OCRDs might result in extreme useful impairment and will negatively affect parenting. The OCRDs, particularly these which can be extra body-focused, have the potential to emerge or worsen throughout being pregnant and the postpartum interval; ladies ought to thus be monitored carefully all through being pregnant and the postpartum interval for OCRD signs as these signs are related to worse postpartum functioning and will enhance threat for postpartum melancholy.
Victoria Canelos, MD
Miller ML, Roche AI, Lemon E, O’Hara MW. Obsessive-compulsive and related disorder symptoms in the perinatal period: prevalence and associations with postpartum functioning. Arch Womens Ment Well being. 2022 Aug; 25(4):771-780.
