Phenomenology of perinatal obsessive–compulsive disorder

Abstract This chapter focuses on the phenomenology of obsessive–compulsive disorder symptoms that develop or worsen perinatally. The content of obsessions and nature of the compulsions during this period are generally related to the protection of an unborn or newborn child and most commonly involve contamination fears during pregnancy and intrusive thoughts about harm during the postpartum period. Comorbid depressive symptoms are often present as well. Perinatal OCD symptoms are maintained by the misinterpretation of intrusive thoughts as highly significant and meaningful, overestimates of threat and responsibility for preventing harm, compulsive rituals, and avoidance of fear cues. Although research has documented an increased risk of OCD during pregnancy and the postpartum period, perinatal OCD is understudied and underrecognized relative to depression and psychosis.