Obsessive-compulsive disorders

Obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder with a multifactorial etiology. Biological and psychosocial factors play a key role in modulating the liability to OCD. Pregnancy, especially the third trimester, and the postpartum period are at risk of onset, recurrence, or exacerbation of OCD, leading to severe suffering and impairment for the patient, the baby, and the family as well. Peripartum OCD is more likely to be characterized by aggressive thoughts focused on the baby and obsessions about contamination with associated compulsions involving repetitive checking and cleaning. Perinatal OCD symptoms may cause severe personal distress, significant levels of anxiety, and feelings of guilt. Consequently, women are unlikely to report obsessional thoughts to family or healthcare professionals, and perinatal OCD is undetected and untreated. Timely diagnosis and effective treatments should be offered to patients in order to avoid persistent impairment in family life and activities of daily living, as well as extensive family involvement and accommodation of OCD symptoms, with a burden that leads families to increase their distress and reduce their global functioning. The purpose of the present chapter is to address prevalence, etiopathogenesis, clinical features, and clinical management of peripartum OCD.