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Gebelik ve Postpartum Dönemde Obsesif Kompulsif Bozukluk

Year 2018, Volume: 10 Issue: 1, 118 - 129, 31.03.2018
https://doi.org/10.18863/pgy.336626

Abstract

Gebelik ve postpartum dönem birçok psikiyatrik hastalığın gelişmesi veya alevlenmesi açısından riskli dönemlerdir. Genel kanı gebelik ve postpartum dönemde obsesif kompulsif bozukluğun genel topluma göre sıklığının daha yüksek olduğu yönündedir. Bu dönemlerde obsesyon ve kompulsiyonların varlığı gözden kaçırılmamalıdır. Sıklıkla bulaşma ve saldırganlıkla ilişkili obsesyonlar; yıkama-temizleme yönünde kompulsiyonlar görülmektedir. Tedavide ilk tercih selektif serotonin geri alım inhibitörleri ve bilişsel davranışçı terapidir. Bu yazıda gebelik ve postpartum dönemde obsesif kompulsif bozukluğun sıklığı, etiyolojisi, komorbiditesi, klinik özellikleri ve tedavisi kısaca gözden geçirilmiştir.

References

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  • Abramowitz JS, Nelson CA, Rygwall R, Khandker M (2007) The cognitive mediation of obsessive-compulsive symptoms: a longitidunal study. J Anxiety Disord, 21:91-104.
  • Abramowitz JS, Schwartz SA, Moore KM, Luenzmann KR (2003) Obsessive-compulsive symptoms in pregnancy and puerperium: a review of the literature. J Anxiety Disord, 17:461-478.
  • ACOG Committee on Practice Bulletins-Obstetrics (2008) Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol, 111:1001-1020.
  • Andrade SE, McPhillips H, Loren D, Raebel MA, Lane K, Livingston J et al. (2009) Antidepressant medication use and the risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf, 18:246-52.
  • Arch JJ, Dimidjian S, Chessick C (2012) Are exposure-based cognitive behavioral therapies safe during pregnancy. Arch Women Ment Health, 15:445-447.
  • Arnold LM (1999) A case series of women with postpartum-onset obsessive-compulsive disorder. Primary Care Companion J Clin Psychiatry, 1:103-108.
  • Belik J (2008) Fetal and neonatal effects of maternal drug treatment for depression. Semin Perinatol, 32:350-354. Björgvinsson T, Hart J, Hefelfinger S (2007) Obsessive-compulsive disorder: update on assesment and treatment. J Psychiatr Pract, 13:362-372.
  • Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF (2006) A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry, 11:622-632.
  • Brandes M, Soares CN, Cohen LS (2004) Postpartum onset obsessive-compulsive disorder: diagnosis and management. Arch Women Ment Health, 7:99-110.
  • Brockington IF, Macdonald E, Wainscott G (2006) Anxiety, obsessions and morbid preoccupations in pregnancy and puerperium. Arch Women Ment Health, 9:253-263.
  • Challacombe FL, Salkovskis PM (2011) Intensive cognitive-behavioral treatment for women with postnatal obsessive compulsive disorder: a consecutive case series. Behav Res Ther, 49:422-426.
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  • Cole JA, Ephross SA, Cosmatos IS, Walker AM (2007) Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf, 16:1075-1085.
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  • Gentile S (2007a) Serotonin reuptake inhibitor-induced perinatal complications. Pediatr Drugs, 9:97-106.
  • Gentile S (2007b) Use of contemporary antidepressants during breasfeeding: a proposal for a specific safety index. Drug Saf, 30:107-121.
  • Gentile S (2014) Tricyclic antidepressants in pregnancy and puerperium. Expert Opin Drug Saf, 13:207-225.
  • Guglielmi V, Vulink NC, Denys D, Wang Y, Samuels JF, Nestadt G (2014) Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study. Depress Anxiety, 31:979-987.
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  • Ingram IM (1961) Obsessional illness in mental hospital patients. Br J Psychiatry, 107:382-402.
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  • Kallen B, Otterblad-Olausson P (2008) Maternal use of selective re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf, 17:801-806.
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  • Kitamura T, Yoshida K, Okano T, Kinoshita K, Hayashi M, Toyoda N et al. (2006) Multicentre prospective study of perinatal depression in Japan: incidence and correlates of antenatal and postnatal depression. Arch Women Ment Health, 9:121-130.
  • Klinger G, Stahl B, Fusar-Poli P, Merlob P (2013) Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev, 10:308-317.
  • Kolada JL, Bland RC, Newman SC (1994) Obsessive compulsive disorder. Acta Psychiatr Scand, 76(suppl 3):24-35.
  • Konuk N, Öztürk Ü, Karakuş G, Tamam L (2007) Postpartum obsesif kompulsif bozukluk: bir gözden geçirme. Klinik Psikofarmakol Bulteni, 17:142-146.
  • Koren G, Matsui D, Einarson A, Knoppert D, Steiner M (2005) Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates? CMAJ, 172: 1457-1459.
  • Labad J, Alonso P, Segalas C, Reval E, Jimenez S, Bueno B et al. (2010) Distinct correlates of hoarding and cleaning symptom dimensions in relation to onset of obsessive-compulsive disorder at menarche or perinatal period. Arch Women Ment Health, 13:75-81.
  • Labad J, Menchon JM, Alonso P, Segalas C, Jimenez S, Vallejo J (2005) Female reproductive cycle and obsessive-compulsive disorder. J Clin Psychiatry, 66:428-435.
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  • Miller ES, Hoxha D, Wisner KL, Gossett DR (2015) Obsessions and compulsions in postpartum women without obsessive compulsive disorder. J Women Ment Health, 24:825-830.
  • Navarro P, Garcia-Esteve L, Ascaso C, Aguado J, Gelabert E, Martin-Santos R (2008) Non-psychotic psychiatric disorders after childbirth: Prevalence and comorbidity in a community sample. J Affect Disord, 109:171-176.
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Obsessive Compulsive Disorder in Pregnancy and Postpartum Period

Year 2018, Volume: 10 Issue: 1, 118 - 129, 31.03.2018
https://doi.org/10.18863/pgy.336626

Abstract

Pregnancy and postpartum period are risky periods about occurrence and recurrence of many psychiatric disorders. General opinion is that obsessive compulsive disorder is more common in pregnancy and postpartum period than the normal population. Obsessions and compulsions should be questionned in these periods. Obsessions are generally about contagion and agression, compulsions are generally about washing and cleaning. Selective serotonin reuptake inhibitors and cognitive behavioral therapy are the first rank treatment options. In this article we briefly reviewed prevalence, etiology, comorbidities, clinical features and treatment options of obsessive compulsive disorder in pregnancy and postpartum period.

References

  • Abramowitz JS, Meltzer-Brody S, Leserman J, Killenberg S, Rinaldi K, Mahaffey BL et al. (2010) Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. Arch Women Ment Health, 13:523-530.
  • Abramowitz JS, Nelson CA, Rygwall R, Khandker M (2007) The cognitive mediation of obsessive-compulsive symptoms: a longitidunal study. J Anxiety Disord, 21:91-104.
  • Abramowitz JS, Schwartz SA, Moore KM, Luenzmann KR (2003) Obsessive-compulsive symptoms in pregnancy and puerperium: a review of the literature. J Anxiety Disord, 17:461-478.
  • ACOG Committee on Practice Bulletins-Obstetrics (2008) Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol, 111:1001-1020.
  • Andrade SE, McPhillips H, Loren D, Raebel MA, Lane K, Livingston J et al. (2009) Antidepressant medication use and the risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf, 18:246-52.
  • Arch JJ, Dimidjian S, Chessick C (2012) Are exposure-based cognitive behavioral therapies safe during pregnancy. Arch Women Ment Health, 15:445-447.
  • Arnold LM (1999) A case series of women with postpartum-onset obsessive-compulsive disorder. Primary Care Companion J Clin Psychiatry, 1:103-108.
  • Belik J (2008) Fetal and neonatal effects of maternal drug treatment for depression. Semin Perinatol, 32:350-354. Björgvinsson T, Hart J, Hefelfinger S (2007) Obsessive-compulsive disorder: update on assesment and treatment. J Psychiatr Pract, 13:362-372.
  • Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF (2006) A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry, 11:622-632.
  • Brandes M, Soares CN, Cohen LS (2004) Postpartum onset obsessive-compulsive disorder: diagnosis and management. Arch Women Ment Health, 7:99-110.
  • Brockington IF, Macdonald E, Wainscott G (2006) Anxiety, obsessions and morbid preoccupations in pregnancy and puerperium. Arch Women Ment Health, 9:253-263.
  • Challacombe FL, Salkovskis PM (2011) Intensive cognitive-behavioral treatment for women with postnatal obsessive compulsive disorder: a consecutive case series. Behav Res Ther, 49:422-426.
  • Chaudron LH, Nirodi N (2010) The obsessive-compulsive spectrum in the perinatal period: a prospective pilot study. Arch Women Ment Health, 13:403-410.
  • Cho MJ, Kim JK, Jeon HJ, Suh T, Chung IW, Hong JP et al. (2007) Lifetime and 12-month prevalence of DSM-IV psychiatric disorders among Korean adults. J Nerv Ment Dis, 195:203-210.
  • Coelho FM, Silva RA, Quevedo LA, Souza LD, Pinheiro KA, Pinheiro RT (2014) Obsessive-compulsive disorder in fathers during pregnancy and postpartum. Rev Bras Psiquiatr, 36:271-273.
  • Cole JA, Ephross SA, Cosmatos IS, Walker AM (2007) Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf, 16:1075-1085.
  • Çilli AS, Telcioğlu M, Aşkın R, Kaya N, Bodur S, Kucur R (2004) Twelve-month prevalence of obsessive compulsive disorder in Konya, Turkey. Compr Psychiatry, 45:367-374.
  • Dold M, Aigner M, Lanzenberger R, Kasper S (2013) Antipsychotic augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a meta-analysis of double-blind, randomized, placebo-controlled trials. Int J Neuropsychopharmacol, 16:557-574.
  • Eggermont E (1973) Withdrawal symptoms in neonates associated with maternal imipramine therapy. Lancet, 2(7830):675-680.
  • Einarson A, Choi J, Einarson TR, Koren G (2009) Incidence of major malformations in infants following antidepresant exposure in pregnancy: results of a large prospective cohort study. Can J Psychiatry, 54:242-246.
  • Epperson CN, Mcdougle CJ, Price LH (1996) Intranasal oxytocin in obsessive-compulsive disorder. Biol Psychiatry, 40:547-549.
  • Fairbrother N, Abramowitz JS (2007) New parenthood as a risk factor for the development of obsessional problems. Behav Res Ther, 45:2155-2163.
  • Faisal-Cury A, Menezes P, Araya R, Zugaib M (2009) Common mental disorders during pregnancy: prevalence and associated factros among low-income women in Sao Paulo, Brazil. Arch Women Ment Health, 12:335-339.
  • Farias DR, Pinto T, Teofilo MM, Vilea AA, Vaz S, Nardi AE et al. (2013) Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk. Psychiatry Res, 210:962-968.
  • Felice E, Saliba J, Grech V, Coks J, Calleja N (2007) Antenatal psychiatric morbidity in Maltase women. Gen Hosp Psychiatry 29:501-505.
  • Foa EB, Franklin ME (2011) Treatment of obsessive-compulsive disorder. Ann Rev Clin Psychol, 7:229-243.
  • Fontenelle LF, Mendlowicz MV, Versiani M (2006) The descriptive epidemiology of obsessive-compulsive disorder. Prog Neuro-Psychopharmacol Biol Psychiatry, 30:327-337.
  • Forray A, Focseneanu M, Pittman B, McDougle CJ, Epperson CN (2010) Onset and exacerbation of obsessive-compulsive disorder in pregnancy and postpartum period. J Clin Psychiatry, 71:1061-1068.
  • Gentile S (2007a) Serotonin reuptake inhibitor-induced perinatal complications. Pediatr Drugs, 9:97-106.
  • Gentile S (2007b) Use of contemporary antidepressants during breasfeeding: a proposal for a specific safety index. Drug Saf, 30:107-121.
  • Gentile S (2014) Tricyclic antidepressants in pregnancy and puerperium. Expert Opin Drug Saf, 13:207-225.
  • Guglielmi V, Vulink NC, Denys D, Wang Y, Samuels JF, Nestadt G (2014) Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study. Depress Anxiety, 31:979-987.
  • Humenik ALF, Fingerhut R (2007) A pilot study assessing the relationship between child harming thoughts and postpartum depression. J Clin Psychol Med Settings, 14:360-366.
  • Ingram IM (1961) Obsessional illness in mental hospital patients. Br J Psychiatry, 107:382-402.
  • Jennings KD, Ross S, Popper S, Elmore M (1999) Thoughts of harming infants in depressed and nondepressed mothers. J Affect Disord, 54:21-28.
  • Kallen B, Otterblad-Olausson P (2008) Maternal use of selective re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf, 17:801-806.
  • Kaya V, Uguz F, Sahingoz M, Gezginc K (2015) Pregnancy-onset obsessive-compulsive disorder: clinical features, comorbidity and associated factors. Bull Clin Psychopharmacol, 25:248-258.
  • Kellner M (2010) Drug treatment of obsessive-compulsive disorder. Dialogues Clin Neurosci, 12:187-197.
  • Kitamura T, Yoshida K, Okano T, Kinoshita K, Hayashi M, Toyoda N et al. (2006) Multicentre prospective study of perinatal depression in Japan: incidence and correlates of antenatal and postnatal depression. Arch Women Ment Health, 9:121-130.
  • Klinger G, Stahl B, Fusar-Poli P, Merlob P (2013) Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev, 10:308-317.
  • Kolada JL, Bland RC, Newman SC (1994) Obsessive compulsive disorder. Acta Psychiatr Scand, 76(suppl 3):24-35.
  • Konuk N, Öztürk Ü, Karakuş G, Tamam L (2007) Postpartum obsesif kompulsif bozukluk: bir gözden geçirme. Klinik Psikofarmakol Bulteni, 17:142-146.
  • Koren G, Matsui D, Einarson A, Knoppert D, Steiner M (2005) Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates? CMAJ, 172: 1457-1459.
  • Labad J, Alonso P, Segalas C, Reval E, Jimenez S, Bueno B et al. (2010) Distinct correlates of hoarding and cleaning symptom dimensions in relation to onset of obsessive-compulsive disorder at menarche or perinatal period. Arch Women Ment Health, 13:75-81.
  • Labad J, Menchon JM, Alonso P, Segalas C, Jimenez S, Vallejo J (2005) Female reproductive cycle and obsessive-compulsive disorder. J Clin Psychiatry, 66:428-435.
  • Lopez-Ibor JJ (1988) The involvement of serotonin in psychiatric disorders and behaviour. Br J Psychiatry, 153:26-39.
  • Lord C, Steiner M, Soares CN, Carew CL, Hall GB (2012) Stress response in postpartum women with/without obsessive compulsive symptoms: an fMRI study. J Psychiatry Neurosci, 37:78-86.
  • Maina G, Albert U, Bogetto F, Vaschetto P, Ravizza L et al. (1999) Recent life events and obsessive-compulsive disorder (OCD): the role of pregnancy delivery. Psychiatry Res, 89:49-58.
  • Mc Dougle CJ, Epperson CN, Pelton GH, Wasylink S (2000) A double-blind, placebo-controlled study of risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder. Arch Gen Psychiatry, 57:794-801.
  • Miller ES, Hoxha D, Wisner KL, Gossett DR (2015) Obsessions and compulsions in postpartum women without obsessive compulsive disorder. J Women Ment Health, 24:825-830.
  • Navarro P, Garcia-Esteve L, Ascaso C, Aguado J, Gelabert E, Martin-Santos R (2008) Non-psychotic psychiatric disorders after childbirth: Prevalence and comorbidity in a community sample. J Affect Disord, 109:171-176.
  • Neziroglu F, Anemone R, Yaryura-Tobias JA (1992) Onset of obsessive-compulsive disorder in pregnancy. Am J Psychiatry, 149:947-950.
  • Nordeng H, Lindemann R, Perminov KV, Reikvam A (2001) Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr, 90:288-291.
  • O’Sullivan G, Noshirvani H, Marks I, Monteiro W, Lelliott P (1991) Six year follow-up after exposure and clomipramine therapy for obsessive compulsive disorder. J Clin Psychiatry, 52:150-155.
  • Öztürk O, Uluşahin A (2015) Ruh Sağlığı ve Bozuklukları. Gözden geçirilmiş ve yenilenmiş 13. Baskı. Ankara, Nobel Yayınevi.
  • Pollitt J (1957) Natural history of obsessional states. Br Med J, 1:194-198.
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There are 83 citations in total.

Details

Primary Language Turkish
Subjects Psychiatry, Behaviour-Personality Assessment in Psychology
Journal Section Review
Authors

Mehmet Emin Demirkol 0000-0003-3965-7360

Lütfiye Şimşek This is me

Hamdi Yılmaz This is me

Lut Tamam 0000-0002-9750-7531

Publication Date March 31, 2018
Acceptance Date May 11, 2017
Published in Issue Year 2018 Volume: 10 Issue: 1

Cite

AMA Demirkol ME, Şimşek L, Yılmaz H, Tamam L. Gebelik ve Postpartum Dönemde Obsesif Kompulsif Bozukluk. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. March 2018;10(1):118-129. doi:10.18863/pgy.336626

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