POSTPARTUM OBSESSIVE-COMPULSIVE DISORDER - A CASE SERIES

Background: The puerperium has typically been a period of risk for the development of psychiatric illness. Although postpartum depressive il lness has been discussed extensively in the literature, obsessive comp ulsive disorder during pregnancy and puerperium has received little at tention . Method: Fifteen women with new-onset obsessive compulsive sy mptoms during the puerperium were retrospectively evaluated by chart r eview; all met DSM-III-R criteria for obsessive compulsive disorder. D istinctive features of their clinical presentation, pharmacotherapy re ceived. and status at 1-year follow-up were recorded. Results: Patient s were noted to have a characteristic constellation of symptoms compri sed of disabling intrusive obsessional thoughts to harm their babies. Obsessive rituals were not observed in any of the patients described. Patients frequently developed secondary depression and appeared to be exquisitely responsive to serotonin selective reuptake inhibitors. Con clusion: The puerperium may be a period of risk for development of new -onset obsessive compulsive disorder. Clinicians caring for puerperal women need to be aware of the impact of these symptoms on maternal and fetal well-being.