Obsessive-compulsive disorder in the perinatal period: Epidemiology, phenomenology, pathogenesis, and treatment. [Trastorno obsesivo-compulsivo durante el período perinatal: epidemiología, fenomenología, etiopatogenia y tratamiento

Abstract

The aim of this review is to describe the main theoretical find- ings and research conclusions about obsessive-compulsive disorder (OCD) in the perinatal period. On one hand, epidemiological studies show that the risk of OCD onset and/or exacerbation could increase in this period, par- ticularly in the puerperium. Phenomenologically, in this stage aggressive and contamination obsessions are very common and are related to the fe- tus or newborn. On the other hand, regarding OCD pathogenesis in this period, there is indirect evidence to suggest the participation of neuroendo- crine (e.g. female gonadal steroids and oxytocin) and cognitive behavioural variables (e.g. hyper-responsibility, threat overestimation, and mental con- trol). In terms of research, more empirical studies are needed to contrast these specific vulnerability factors. Moreover, no empirically validated psy- chotherapeutic treatments (controlled trials) adapted to this OCD sub- group were found, although some studies highlight the role of cognitive behavioural therapy (CBT) as an effective intervention in the context of se- lective primary prevention.