Female Reproductive Cycle and Obsessive-Compulsive Disorder
J Clin Psychiatry 2005;66(4):428-435
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Background: The aim of our study was to assess
whether there is a relationship between reproductive cycle events
and the initiation or changes in symptoms of obsessive-compulsive
Method: Forty-six female outpatients meeting
DSM-IV criteria for OCD completed a semistructured interview at
our OCD unit to assess the relationship between reproductive
cycle events and OCD. Dates of data collection were from January
2001 to December 2003.
Results: In our sample, OCD onset occurred in
the same year as menarche in 22% (N = 10), at pregnancy in 2%
(N = 1), at postpartum in 7% (N = 3), and at menopause in 2% (N = 1).
Worsening of preexisting OCD was reported by 20% of patients
(9/45) at premenstruum, 8% (1/12) at pregnancy, 50% (6/12) at
postpartum, and 8% (1/12) at menopause. The number of
premenstrual mood symptoms, which included anxiety, irritability,
mood lability and depressed mood, was associated with both
premenstrual worsening of OCD (OR = 5.1, p < .01) and onset or
worsening of OCD at postpartum (OR = 2.7, p < .05). Patients with
an onset or worsening of OCD at postpartum also more frequently
reported premenstrual worsening of OCD and previous history of
major depressive disorder, including postpartum depression
(p < = .05 for all).
Conclusion: In a substantial number of patients,
the onset or worsening of OCD was related to reproductive cycle
events, especially at menarche and postpartum. Certain women with
OCD seem to be vulnerable to worsening of OCD at different
reproductive periods that imply hormonal fluctuations, and
premenstruum and postpartum were the 2 reproductive events with a
greater vulnerability. Those patients whose OCD symptoms appeared
to be related to reproductive events also exhibited a greater
history of mood symptoms (premenstrual depression and major