Obsessive-Compulsive Disorder in Pregnancy and Postpartum
Bibliographic record
Abstract
Role and Implications of Obsessive-Compulsive Personality DisorderTo the Editor: We read with interest a recent publication by Fairbrother and colleagues. 1 The authors assessed the prevalence and incidence of maternal obsessive-compulsive disorder (OCD) between the third trimester of pregnancy and 6 months postpartum in 763 pregnant women.Weighted prenatal and postnatal prevalence of 7.8% and 16.9% was calculated.Point prevalence gradually increased over the course of pregnancy and postpartum, with a peak of 9% about 8 weeks postpartum. 1 Previous data from the literature indicate a prevalence of around 2% during pregnancy and 2.38% in the postpartum vs 1% in the general female population. 2 Several studies provide evidence supporting more frequent OCD symptoms in the perinatal period, but a clear analysis of risk factors and reasons is still lacking.2 Obsessive-compulsive personality disorder (OCPD) is among the risk factors for the development of OCD.3,4 OCPD is marked by an excessive obsession with rules, lists, schedules, and order; a need for perfectionism that interferes with efficiency and the ability to complete tasks; a devotion to productivity that hinders interpersonal relationships and leisure time; rigidity and zealousness on matters of morality and ethics; an inability to delegate responsibilities or work to others; restricted functioning in interpersonal relationships; restricted expression of emotion and affect; and a need for control over one's environment and self.3 It has a prevalence of 2.1%-7.9% in the general population, with a peak of 8.7% in the clinical population.We analyzed 215 pregnant women with the Structured Clinical Interview for DSM-5 Axis I and II Disorders.Thirty-one of them had OCPD (14.41%), while 3 showed the onset of OCD (1.4%).With regard to their reproductive health, women with OCPD showed more voluntary termination of pregnancy (16.1% vs 11.9%, P = NS); more complications during pregnancy, labor, and delivery (77.8% vs 12.5%, P < .0001),including emergency cesarean sections (19.4% vs 6.25%, P = NS); and used more contraceptive pills (61.3% vs 32.2%, P = .008).A possible gap in the explanation of a high prevalence of OCD in the perinatal period might be accounted for by a significantly higher prevalence of acknowledged risk factors like OCPD.3,4 The extent of OCPD detected in our sample could justify epidemiologic data underlined by Fairbrother et al, while clinical implications highlighted in women affected by OCPD (eg, significantly higher prevalence of voluntary termination of pregnancy and complications during pregnancy and delivery) emphasize the need for early detection and treatment to prevent adverse outcomes in mother and child.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".