Gebelik ve Postpartum Dönemde Obsesif Kompulsif Bozukluk

Yıl 2018, , 118 - 129, 31.03.2018

Mehmet Emin Demirkol , Lütfiye Şimşek Hamdi Yılmaz Lut Tamam

https://doi.org/10.18863/pgy.336626

Cited By: 2

Öz

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.

Anahtar Kelimeler

Obsesif kompulsif bozukluk, gebelik, postpartum dönem

Obsessive Compulsive Disorder in Pregnancy and Postpartum Period

Öz

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.

Anahtar Kelimeler

Obsessive compulsive disorder, pregnancy, postpartum period

Kaynakça

• 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.
• Reis M, Källén B (2010) Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med, 40:1723-1733.
• Riggin L, Frankel Z, Moretti M, Pupco A, Koren G (2013) The fetal safety of fluoxetine: a systematic review and meta-analysis. J Obstet Gynaecol Can, 35:362-369.
• Roca A, Garcia-Esteve LI, Imaz ML, Torres A, Hernandez S, Botet F et al. (2011) Obstetrical and neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitors: the relevance of dose. J Affect Disord, 135:208-215.
• Russel EJ, Fawcett JM, Mazmanian D (2013) Risk of obsessive compulsive disorder in pregnant and postpartum women: a meta-analysis. J Clin Psychiatry, 74:377-385.
• Salkovskis PM (1999) Understanding and treating obsessive-compulsive disorder. Behav Res Ther, 37:29-52.
• Salkovskis PM (2004) Psyhological treatment for obsessive compulsive disorder. Psychiatry, 3:68-72.
• Sanz EJ, De-las-Cuevas C, Kiuru A, Bate A, Edwards R (2005) Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a data base analysis. Lancet, 365:482-487.
• Shear MK, Mammen O (1995) Anxiety disorders in pregnant and postpartum women. Psychopharmacol Bull, 31:693-703.
• Sichel DA, Cohen LS, Dimmock JA, Rosenbaum JF (1993) Postpartum obsessive-compulsive disorder: a case series. J Clin Psychiatry, 54:156-159.
• Speisman BB, Storch EA, Abramowitz JS (2011) Postpartum obsessive-compulsive disorder. J Obstet Gynecol Neonatal Nurs, 40:680-690.
• Suri R, Altshuler L, Hellemann G, Burt VK, Aquino A, Mintz J (2007) Effects of antenatal depression and antidepressant treatment on gestational age at birth and risk of preterm birth. Am J Psychiatry, 164:1206-1213.
• Sutter-Dallay AL, Giaconne-Marcesche V, Verdeoux H (2004) Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry, 19:459-463.
• Tükel R, Demet MM, Topçuoğlu VO, (2006) Obsesif kompulsif bozukluğun fenomenolojisi. In Anksiyete Bozuklukları (Eds R Tükel, T Alkın): 277-298. Ankara, Türkiye Psikiyatri Derneği Yayınları.
• Uguz F (2012) Hamilelik ve obsesif kompulsif bozukluk. Türkiye Klinikleri Psikiyatri Dergisi, 5:85-90.
• Uguz F (2015) Pharmacotherapy of obsessive-compulsive disorder during pregnancy: a clinical approach. Rev Bras Psiquiatr, 37:334-342.
• Uguz F, Akman C, Kaya N, Cilli AS (2007) Postpartum-onset obsessive-compulsive disorder: incidence, clinical features and related factors. J Clin Psychiatry, 68:132-138.
• Van Ameringen M, Simpson W, Patterson B, Dell’Osso B, Fineberg N, Hollander E et al. (2014) Pharmacological treatment strategies in obsessive compulsive disorder: a cross-sectional view in nine international OCD centers. J Psychopharmacol, 28:596-602.
• Vicente B, Kohn R, Rioseco P, Saldivia S, Baker C, Torres S (2004) Population prevalence of psychiatric disorders in Chile:6-month and 1-month rates. Br J Psychiatry, 84:299-305.
• Vicente B, Kohn R, Rioseco P, Saldivia S, Levav I, Torres S (2006) Lifetime and 12-month prevalence of DSM-III-R disorders in the Chile Psychiatric Prevalence Study. Am J Psychiatry, 163:1362-1370.
• Weissman MM, Bland RC, Canino GL, Greenwald S, Hwu HG, Lee CK et al. (1994) The cross national epidemiology of obsessive compulsive disorder. J Clin Psychiatry, 55(Suppl 3):5-10.
• Wenzel A, Gorman LL, O’Hara MW, Stuart S (2001) The occurence of panic and obsessive-compulsive symptoms in women with postpartum dsyphoria: a prospective study. Arch Women Ment Health, 4:5-12.
• Wenzel A, Haugen E.N, Jackson L.C, Brendle JR (2005) Anxiety symptoms and disorders at eight weeks postpartum. J Anxiety Disord, 19:295-311.
• Williams KE, Koran LM (1997) Obsessive-compulsive disorder in pregnancy, the puerperium, and the premenstrum. J Clin Psychiatry, 58:330-334.
• Wisner KL, Peindl KS, Gigliotti T, Hanusa BH (1997) Obsessions and compulsions in women with postpartum depression. J Clin Psychiatry, 60:176-180.
• Yonkers KA, Wisner KL, Stewart DE, Oberlander TF, Dell DL, Stotland N, et al. (2009) The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Gen Hosp Psychiatry, 31:403-413.
• Zambaldi CF, Cantilino A, Montenegro AC, Paes JA, de Albuquerque TL, Sougey EB (2009) Postpartum obsessive-compulsive disorders: prevalence and clinical characteristics. Compr Psychiatry, 50:503-509.
• Zar M,Wijma K, Wijma B (2002) Relations between anxiety disorders and fear of childbirth during late pregnancy. Clin Psychol Psychother, 9:122-130.