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Perinatal OCD

S Zullino, T Simoncini
SSRIs are the first choice for the treatment of mood disorders during pregnancy and lactation. Despite the known side effects, the benefits/risks balance suggests their use. Hypertensive disorders of pregnancy (HDP) and Intrauterine growth restriction (IUGR) are the main vascular effects of these drugs, with mechanisms that involves endothelial dysfunction in feto-placental system. These data are supported by animal models, even if preliminary findings are not yet adequately supported by molecular and clinical data...
May 24, 2018: Vascular Pharmacology
Brenda Leung, Nicole Letourneau, Katherine Bright, Gerald F Giesbrecht, Henry Ntanda, Lisa Gagnon
BACKGROUND: Depression and anxiety are routinely screened as part of perinatal care. However, other Axis 1 disorders and specific anxiety disorders are less likely to be screened or assessed as part of obstetric care. The objective of this study was to determine whether the Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a potentially useful tool to screen for psychiatric conditions in pregnant and postpartum women in a community setting. METHODS: We compared the prevalence of DSM Axis I disorders obtained on the PDSQ with: (1) the prevalence of these disorders reported in previous studies of pregnant and postpartum women, and (2) scores obtained on the Edinburgh Postpartum Depression Scale (EPDS) and the Symptom Checklist-90-Revised (SCL-90R) anxiety scale...
August 2017: Scandinavian Journal of Public Health
F L Challacombe, P M Salkovskis, M Woolgar, E L Wilkinson, J Read, R Acheson
BACKGROUND: There is increasing recognition that perinatal anxiety disorders are both common and potentially serious for mother and child. Obsessive-compulsive disorder (OCD) can be triggered or exacerbated in the postpartum period, with mothers reporting significant effects on parenting tasks. However, there is little evidence concerning their effective treatment or the impact of successful treatment on parenting. METHOD: A total of 34 mothers with OCD and a baby of 6 months old were randomized into either time-intensive cognitive-behaviour therapy (iCBT) or treatment as usual (TAU)...
June 2017: Psychological Medicine
Gustaf Brander, Mina Rydell, Ralf Kuja-Halkola, Lorena Fernández de la Cruz, Paul Lichtenstein, Eva Serlachius, Christian Rück, Catarina Almqvist, Brian M D'Onofrio, Henrik Larsson, David Mataix-Cols
Importance: Perinatal complications may increase the risk of obsessive-compulsive disorder (OCD). Previous reports were based on small, retrospective, specialist clinic-based studies that were unable to rigorously control for unmeasured environmental and genetic confounding. Objective: To prospectively investigate a wide range of potential perinatal risk factors for OCD, controlling for unmeasured factors shared between siblings in the analyses. Design, Setting, and Participants: This population-based birth cohort study included all 2 421 284 children from singleton births in Sweden from January 1, 1973, to December 31, 1996, who were followed up through December 31, 2013...
November 1, 2016: JAMA Psychiatry
Mohamed Abdulkadir, Jay A Tischfield, Robert A King, Thomas V Fernandez, Lawrence W Brown, Keun-Ah Cheon, Barbara J Coffey, Sebastian F T M de Bruijn, Lonneke Elzerman, Blanca Garcia-Delgar, Donald L Gilbert, Dorothy E Grice, Julie Hagstrøm, Tammy Hedderly, Isobel Heyman, Hyun Ju Hong, Chaim Huyser, Laura Ibanez-Gomez, Young Key Kim, Young-Shin Kim, Yun-Joo Koh, Sodahm Kook, Samuel Kuperman, Andreas Lamerz, Bennett Leventhal, Andrea G Ludolph, Marcos Madruga-Garrido, Athanasios Maras, Marieke D Messchendorp, Pablo Mir, Astrid Morer, Alexander Münchau, Tara L Murphy, Thaïra J C Openneer, Kerstin J Plessen, Judith J G Rath, Veit Roessner, Odette Fründt, Eun-Young Shin, Deborah A Sival, Dong-Ho Song, Jungeun Song, Anne-Marie Stolte, Jennifer Tübing, Els van den Ban, Frank Visscher, Sina Wanderer, Martin Woods, Samuel H Zinner, Matthew W State, Gary A Heiman, Pieter J Hoekstra, Andrea Dietrich
Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1113 participants from the Tourette International Collaborative Genetics study...
November 2016: Journal of Psychiatric Research
Fiona L Challacombe, Paul M Salkovskis, Matthew Woolgar, Esther L Wilkinson, Julie Read, Rachel Acheson
BACKGROUND: Maternal mental illness is associated with negative effects on the infant and child. Increased attention has been paid to the effects of specific perinatal disorders on parenting and interactions as an important mechanism of influence. OCD can be a debilitating disorder for the sufferer and those around them. Although OCD is a common perinatal illness, no previous studies have characterized parenting and mother infant interactions in detail for mothers with OCD. METHODS: 37 mothers with postpartum OCD and a 6 month old infant were compared with 37 community control dyads on a variety of measures of psychological distress and parenting...
August 2016: Infant Behavior & Development
Nichole Fairbrother, Patricia Janssen, Martin M Antony, Emma Tucker, Allan H Young
BACKGROUND: Anxiety and related disorders (AD) disproportionately affect women, and are the most prevalent of all mental health conditions. The current research represents the first study of maternal postpartum AD prevalence in which all of the AD are assessed, and one of few studies of this type in which maternal prenatal AD incidence is assessed. METHODS: A Canadian sample of pregnant women (N=310) was recruited from a defined geographical area between November 2007 and November 2010...
August 2016: Journal of Affective Disorders
Gustaf Brander, Ana Pérez-Vigil, Henrik Larsson, David Mataix-Cols
OBJECTIVE: To synthesize the current knowledge on possible environmental risk factors for Obsessive-Compulsive Disorder (OCD). METHOD: We conducted a systematic review following PRISMA guidelines. The Embase, PubMed and Scopus databases were searched up until October 6, 2015, employing relevant keywords and MeSH terms. RESULTS: 128 studies met inclusion criteria. Potential environmental risk factors for OCD have been identified in the broad areas of perinatal complications, reproductive cycle, and stressful life events...
June 2016: Neuroscience and Biobehavioral Reviews
Gabriella Francesca Mattina, Meir Steiner
Obsessive-compulsive disorder (OCD) is a heterogeneous mental disorder that significantly impairs an individual's functioning. The candidate gene approach has proven to be a useful tool in investigating potential risk genes for OCD, but genetic studies have been largely inconclusive. Etiologically distinct forms of obsessive-compulsive disorder based on sex and age of onset have been identified, yet many genetic studies fail to examine the association by these subtypes. Due to the sexually dimorphic nature of the disorder, positive associations have been found with OCD in males only, suggesting the potential for identifying risk genes that contribute to OCD in women, such as perinatal OCD...
June 3, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
Faruk Uguz
Obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder in the perinatal period. However, specific pharmacological treatment approaches for patients with OCD during pregnancy have not been satisfactorily discussed in the literature. In addition, there are no randomized controlled studies on the treatment of this disorder during pregnancy. The present paper discusses the pharmacological treatment of OCD in the light of data on the safety of antipsychotics and serotonergic antidepressants during pregnancy and their efficacy in the non-perinatal period...
October 2015: Revista Brasileira de Psiquiatria
C Marchesi, P Ossola, A Amerio, B D Daniel, M Tonna, C De Panfilis
BACKGROUND: In the last few decades, there has been a growing interest in anxiety disorders (AnxD) in the perinatal period. Although AnxD are diagnosed in 4-39% of pregnant women and in up to 16% of women after delivery, evidence on their clinical management is limited. METHODS: A systematic review was conducted on pharmacological and non-pharmacological treatment of AnxD in the perinatal period. Relevant papers published from January 1st 2015 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library...
January 15, 2016: Journal of Affective Disorders
Timothy H Ciesielski, Carmen J Marsit, Scott M Williams
BACKGROUND: We sought to identify and characterize predictors of poor fetal growth among variables extracted from perinatal medical records to gain insight into potential etiologic mechanisms. In this process we reevaluated a previously observed association between poor fetal growth and maternal psychiatric disease. METHODS: We evaluated 449 deliveries of >36 weeks gestation that occurred between 9/2008 and 9/2010 at the Women and Infants Hospital in Providence Rhode Island...
August 25, 2015: BMC Pregnancy and Childbirth
Roxanne Barrett, Abigail L Wroe, Fiona L Challacombe
BACKGROUND: The cognitive-behavioural model of perinatal OCD suggests the role of increased sense of responsibility during the perinatal period in the development and maintenance of obsessive-compulsive symptoms. However, the idiosyncratic nature of responsibility attitudes and interpretations of intrusions is not fully understood. AIMS: To investigate how responsibility interpretations regarding intrusions vary across the perinatal period and how this relates to obsessive-compulsive symptomatology...
May 2016: Behavioural and Cognitive Psychotherapy
Susanne Somerville, Shannon L Byrne, Kellie Dedman, Rosemary Hagan, Soledad Coo, Elizabeth Oxnam, Dorota Doherty, Nadia Cunningham, Andrew C Page
BACKGROUND: The Perinatal Anxiety Screening Scale (PASS; Somerville et al., 2014) reliably identifies perinatal women at risk of problematic anxiety when a clinical cut-off score of 26 is used. This study aimed to identify a severity continuum of anxiety symptoms with the PASS to enhance screening, treatment and research for perinatal anxiety. METHODS: Antenatal and postnatal women (n=410) recruited from the antenatal clinics and mental health services at an obstetric hospital completed the Edinburgh Postnatal Depression Scale (EPDS), the Depression, Anxiety and Stress Scale (DASS-21), the Spielberg State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory II (BDI), and the PASS...
November 1, 2015: Journal of Affective Disorders
Samuel J House, Shanti P Tripathi, Bettina T Knight, Natalie Morris, D Jeffrey Newport, Zachary N Stowe
The study aimed to examine the course of obsessive-compulsive disorder (OCD) across pregnancy and its impact on obstetric and neonatal outcomes. Women enrolled prior to 20-week gestation in a prospective, observational study. The Structured Clinical Interview for DSM-IV was completed to obtain lifetime Axis I diagnoses. A total of 56 women with OCD were followed at 1 to 3-month intervals through 52 weeks postpartum. Each visit, the Yale-Brown Obsessive Compulsive Scale (YBOCS), clinical assessment, and medication/exposure tracking were performed...
February 2016: Archives of Women's Mental Health
Ka Taylor, Js Stern, D Williams, Hs Simmons, Mr Robertson
OBJECTIVE: Evidence for the role of complex genetics in the clinical expression of Gilles de la Tourette (GTS) is widespread. Streptococcal autoimmunity as another aetiology is under intense investigation but there is relatively little evidence for other environmental factors. It has long been suggested that perinatal problems increase vulnerability to Tourette syndrome. The aim of this project was to investigate whether prenatal or perinatal complications are associated with an increased tic severity in patients who develop GTS...
August 2014: Journal of Neurology, Neurosurgery, and Psychiatry
David L Pauls, Amitai Abramovitch, Scott L Rauch, Daniel A Geller
Obsessive-compulsive disorder (OCD) is characterized by repetitive thoughts and behaviours that are experienced as unwanted. Family and twin studies have demonstrated that OCD is a multifactorial familial condition that involves both polygenic and environmental risk factors. Neuroimaging studies have implicated the cortico-striato-thalamo-cortical circuit in the pathophysiology of the disorder, which is supported by the observation of specific neuropsychological impairments in patients with OCD, mainly in executive functions...
June 2014: Nature Reviews. Neuroscience
Katherine J Gold, Timothy R B Johnson
INTRODUCTION: Stillbirth and infant death are traumatic events with profound and lasting effects on bereaved families. Mothers with perinatal loss are at high risk for poor mental health, although this has not been well-assessed in a representative epidemiologic cohort. There are also virtually no data on loss among African-American women. METHODS: The Michigan Mother's Study is a 2-year longitudinal survey of all mothers with stillbirth and infant death, matched with live-birth controls...
May 2014: Obstetrics and Gynecology
Shirin Namouz-Haddad, Irena Nulman
QUESTION: My patient is 3 weeks postpartum and has experienced repetitive checking and washing of her newborn as a result of obsessive concerns with the newborn's safety. Should I refer her for a psychiatric assessment to rule out obsessive compulsive disorder (OCD) or should I reassure her that her behaviour is normal? ANSWER: Current data suggest that pregnancy and the postpartum period are times of high risk of OCD onset and exacerbation. The presenting symptoms of OCD overlap with normal concerns and behaviour during the perinatal period; however, an undiagnosed or untreated disorder could have adverse consequences for both the mother and her newborn...
February 2014: Canadian Family Physician Médecin de Famille Canadien
Ting-Kuang Chao, Jing Hu, Tamara Pringsheim
BACKGROUND: Tourette Syndrome (TS) appears to be an inherited disorder, although genetic abnormalities have been identified in less than 1% of patients, and the mode of inheritance is uncertain. Many studies have investigated environmental factors that might contribute to the onset and severity of tics and associated comorbidities such as obsessive compulsive disorder (OCD) and attention deficit hyperactive disorder (ADHD). A systematic review and qualitative analysis were performed to provide a broad view of the association between pre- and perinatal factors and TS...
2014: BMC Pregnancy and Childbirth
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