Almost a fifth of new mothers suffer from obsessive compulsive disorder (OCD), triggered by a fear of their baby being harmed, a new study reveals.
From a sample of hundreds of mothers, researchers found OCD was prevalent in 17 per cent of mothers in the 38 weeks after they gave birth.
OCD symptoms for new mums can include intrusive thoughts involving germs, fears of harm to the baby as a result of neglect or excessive washing of children’s clothes or bottles.
Meanwhile, eight per cent of the new mothers reported OCD symptoms at some point during their pregnancy.
The post-birth, or ‘postpartum’, period has already been associated with mood swings, crying spells, anxiety and difficulty sleeping – known as the ‘baby blues’.
But the researchers warn OCD is another little-known symptom for women both before and after they give birth, which, if left untreated, can interfere with parenting, relationships and daily life.
OCD is characterised by obsessions (recurrent, unwanted, and distressing thoughts, images, or impulses) or compulsions (repetitive mental or behavioural acts). The researchers say thoughts, feelings or acts that meet criteria for a diagnosis of OCD tend to be heightened during pregnancy and after birth, out of fear of harm to their baby
What is obsessive compulsive disorder?
Obsessive compulsive disorder, usually known as OCD, is a common mental health condition which makes people obsess over thoughts and develop behaviour they struggle to control.
It can affect anyone at any age but normally develops during young adulthood.
It can cause people to have repetitive unwanted or unpleasant thoughts.
People may also develop compulsive behaviour – a physical action or something mental – which they do over and over to try to relieve the obsessive thoughts.
The condition can be controlled and treatment usually involves psychological therapy or medication.
It is not known why OCD occurs but risk factors include a family history of the condition, certain differences in brain chemicals, or big life events like childbirth or bereavement.
People who are naturally tidy, methodical or anxious are also more likely to develop it.
The study shows that OCD can affect all perinatal women – both during pregnancy (prenatal) and after the baby is born (postpartum).
The authors are calling for health professionals to be on the lookout for OCD symptoms, which can often go undetected.
‘What really matters now is that we screen for and assess OCD among perinatal women with perinatal-specific questions and assessment methods,’ said study author Dr Nichole Fairbrother at University of British Columbia, Canada.
‘It is especially important that we include questions about intrusive thoughts of infant-related harm.
‘This ensures that perinatal women suffering from OCD are not missed and can be directed toward appropriate treatment.’
Fairbrother and her team surveyed 580 women in British Columbia during their third trimester of pregnancy and for six months afterwards.
Participants completed online questionnaires and interviews designed to assess the presence and severity of OCD symptoms.
The prevalence of OCD among new mothers peaked approximately eight weeks after delivery – 8.7 per cent of the total participants experienced OCD at this point.
Prior research by Dr Fairbrother and colleagues in 2019 had estimated the prevalence of OCD at only about 2.3 per cent during pregnancy and 1.7 per cent in the postpartum period – but this new study shows it’s much higher, at 8 per cent and 17 per cent, respectively.
The team say the new study is one of the first to use newly updated criteria for diagnosing OCD, which lowers the threshold for a diagnosis – and may account for this rise in figures.
By including specific questions about harm to the baby, the researchers were better able to uncover symptoms this time around.
‘The traditional questions are framed in a way that doesn’t really help women connect to the intrusive thoughts they’ve had about their baby,’ said Dr Fairbrother.
‘If they don’t recognise their experience in the questions that are asked, they may be underreporting.’
These questions included: ‘Have you had thoughts or images that your baby might stop breathing?’ and ‘Have you had thoughts, images or impulses of intentionally hitting your baby too hard when burping him/her?’
‘Prior to asking these questions we ensured that participants understood that the kinds of thoughts we were asking about were unwanted and intrusive,’ said Dr Fairbrother.
Data from the new study suggests OCD resolves itself naturally among some women as they become used to parenting, but for others it persists and may require treatment.
It’s important for care providers to know when women are most at risk, because they may be reluctant to report their symptoms, the experts say.
‘When mothers have these kinds of thoughts they might think, “There’s something wrong with me and I can’t tell anyone because there could be terrible consequences for me and my baby”,’ Dr Fairbrother said.
‘Perinatal OCD is common and we have a responsibility to identify those who experience it and ensure they receive timely, evidence-based treatment.’
The study has been published today in the Journal of Clinical Psychiatry.
PATIENTS SUFFERING OCD ARE 10 TIMES MORE LIKELY TO COMMIT SUICIDE
Patients with OCD are 10 times more likely to commit suicide, a 2016 study found.
In order to estimate the risk of suicide among people affected by OCD, researchers at the Karolinska Institutet analysed data from the Swedish national registers, spanning over 40 years.
They identified 36 788 OCD patients in the Swedish National Patient Register between 1969 and 2013, of whom 545 had died by suicide and 4,297 had attempted suicide.
The risk of death by suicide was approximately 10 times higher, and the risk of attempted suicide five times higher than that of the general population.
After adjustment for other psychiatric disorders, the risk was reduced, but remained substantial.
The study authors said: ‘Suicide risk should be carefully monitored in patients with OCD.’
The research contradicted previous beliefs that OCD did very little to drive suicidal thoughts.
About 90 per cent of people who commit suicide are believed to suffer from mental disorders.
But few studies had investigate OCD as one of those disorders.
OCD is one of the most common psychiatric conditions, affecting 3.3 million people in the US and 750,000 people in the UK.
Read the study in Molecular Psychiatry.