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Postpartum-Onset Obsessive-Compulsive Disorder: Incidence, Clinical Features, and Related Factors

Faruk Uguz, M.D.; Cemal Akman, M.D.; Nazmiye Kaya, M.D.; and Ali Savas Cilli, M.D.  

Objective: The aims of this study were to investigate the incidence rate and symptomatology of postpartum-onset obsessive-compulsive disorder (PPOCD), to investigate the factors associated with PPOCD, and to compare clinical characteristics of obsessive-compulsive disorder (OCD) with and without postpartum onset.

Method: The study data were collected from 302 women who delivered at a child and maternity hospital in Turkey from August 2005 to November 2005 and a control group of 33 women who were admitted to the psychiatric outpatient clinic of a university hospital during the same time period and who met DSM-IV criteria for OCD. The 2 clinical interviews with women who delivered were performed face-to-face on the first day after childbirth and at 6 weeks postnatally. OCD and comorbid Axis II disorders were diagnosed by means of the Structured Clinical Interview for DSM-IV and the Structured Clinical Interview for DSM-III-R Personality Disorders, respectively. Obsessive-compulsive symptomatology was assessed with the Yale-Brown Obsessive Compulsive Scale.

Results: The incidence of PPOCD was 4% at 6 weeks postnatally. The most common obsessions in women with PPOCD were contamination (75%), aggressive (33.3%), and symmetry/exactness (33.3%), and the most common compulsions were cleaning/washing (66.7%) and checking (58.3%). The patients with PPOCD had significantly more frequent aggressive obsessions (p = .039) and less severe obsessive-compulsive symptoms (p = .013) than the OCD patients without postpartum onset. The predictors of PPOCD were avoidant (p = .000) and obsessive-compulsive (p = .004) personality disorders.

Conclusions: This study suggests that the puerperium is a risk period in terms of new-onset OCD and that avoidant and obsessive-compulsive personality disorders predict PPOCD.

(J Clin Psychiatry 2007;68:132-138)

Received May 18, 2006; accepted Sept. 12, 2006. From the Department of Psychiatry, Meram Faculty of Medicine, Selcuk University, Konya, Turkey.

The authors report no financial or other relationship relevant to the subject of this article.

Corresponding author and reprints: Faruk Uguz, M.D., Selcuk University, Meram Tąp Fakultesi, Psikiyatri A.D. Meram, Konya 42080, Turkey (e-mail: