An established obsessive compulsive disorder (OCD) in a twenty-six-year-old woman, characterized by obsessional fear of rat germs and ritualistic cleansing, was observed to worsen during pregnancy. The patient's OCD had followed a fluctuating course for three years but she had not previously experienced a decompensation of such duration and severity. During her pregnancy she became depressed and suicidal, was unable to care for her family and spent the majority of her confinement in the hospital. Several mechanisms are discussed which might explain the exacerbation.
Get full access to this article
View all access options for this article.
References
1.
SternR. S. and CobbJ. P., Phenomenology of Obsessive-Compulsive Neurosis, British Journal of Psychiatry, 132, pp. 233–239, 1978.
2.
RobinsL. N.HelzerJ. E.WeissmanM. M.OrvaschelH.GranenbergE.BurkeJ. D., and RegierD. A., Lifetime Prevalence of Specific Psychiatric Disorders in Three Sites, Archives of General Psychiatry, 41, pp. 958–967, 1984.
3.
IngramI. M., Obsessional Illness in Mental Hospital Patients, Journal of Mental Science, 107, pp. 382–402, 1961.
4.
LoW. H., A Follow-Up Study of Obsessional Neurotics in Hong Kong Chinese, British Journal of Psychiatry, 113, pp. 823–832, 1967.
5.
PollittJ., Natural History of Obsessional States, British Medical Journal, 1, pp. 194–198, 1957.
6.
DavidsonJ. and RobertsonE., A Follow-Up Study of Post-Partum Illness, 1946–1978, Acta Psychiatrica Scandinavica, 71, pp. 451–457, 1985.
7.
Jamah-ZadehA.KaneF. J.Van De CastleR. L.LachenbrachP. A., and EwingJ. A., The Emotional and Cognitive Changes in Pregnancy and Early Puerperium, British Journal of Psychiatry, 115, pp. 797–805, 1969.
8.
PollittJ., Obsessional States, British Journal of Psychiatry, Special Publication No. 9, pp. 133–140, 1975.
9.
ButtonJ. and RoivichR., Obsessions of Infanticide, Archives of General Psychiatry, 27, pp. 235–240, 1972.
10.
GoodwinD. W. and GuzeS. B., Psychiatric Diagnosis, p. 16, Oxford University Press, New York, 1984.
11.
JohnsonG. F. S. and LeemanM. M., Onset of Illness in Bipolar Manic-Depressives and their Affectively Ill First Degree Relatives, Biological Psychiatry, 12, pp. 733–741, 1977.
12.
RachmanS. J., Obsessive-Compulsive Disorder: Psychological and Pharmacological Treatment, MavissakalianM.TurnerS., and MichaelsonL. (eds.), PP. 8–9, Plenum Press, New York, 1985.
13.
KringlenE., Natural History of Obsessional Neurosis, Seminars in Psychiatry, 2, pp. 403–419, 1970.
14.
BeechH. R. and VaughanM., The Behavioral Treatment of Obsessional States, p. 152, John Wiley and Sons, New York, 1978.
15.
JenikeM. A., Obsessive Compulsive Disorders: Theory and Management, JenikeM.BaerL., and MinichielloW. (eds.), p. 130, PSG Publishing Co.Littleton, Massachusetts, 1986.
