Perinatal Mental Health Service, Chamomile Suite, The Barberry, 25 Vincent Drive, Edgbaston, Birmingham B15 2SG, UK.
Behav Cogn Psychother. 2011 May;39(3):285-310. doi: 10.1017/S1352465810000718. Epub 2011 Jan 5.
It has been suggested that the perinatal period is a period of increased risk for the development and/or exacerbation of OCD and that postpartum OCD (ppOCD) presents a distinct clinical picture. This raises the possibility that ppOCD might be a distinct subtype of OCD. This review examines this contention.
A search using Ovid (Medline, PsycINFO and Embase), EBSCO, Cochrane Library, Web of Science (ISI), Pubmed databases and Google Scholar was carried out using the key words: "obsessive compulsive disorder" (and derivatives), "perinatal", "pregnancy", "postnatal", "postpartum", "mothers" (and derivatives), "anxiety disorders" and "subtypes." These articles and their references were reviewed.
The majority of studies reviewed were retrospective, which makes it impossible to infer causality. Two prospective studies found a higher incidence of OCD in the postpartum period. These were carried out in Turkey and Brazil and, as such, may be limited in their applicability to other cultural groups.
The concept of ppOCD as a specific subtype has not been robustly demonstrated. The evidence that OCD is more prevalent in the postpartum period is mixed. The evidence that OCD in the postpartum period presents a distinctive clinical picture with specific symptomatology and course is more compelling. In view of the impact of culture and religion on the expression of OCD, collaborative, international, prospective studies that take into account the methodological and definitional issues raised in this review are necessary to provide clarification.
有人认为围产期是强迫症（OCD）发展和/或恶化的风险增加期，产后强迫症（ppOCD）表现出独特的临床特征。这就提出了 ppOCD 可能是 OCD 的一个独特亚型的可能性。本综述检验了这一论点。
使用 Ovid（Medline、PsycINFO 和 Embase）、EBSCO、Cochrane 图书馆、Web of Science（ISI）、Pubmed 数据库和 Google Scholar 进行了搜索，使用的关键词是：“强迫症”（及其派生词）、“围产期”、“妊娠”、“产后”、“产后”、“母亲”（及其派生词）、“焦虑障碍”和“亚型”。审查了这些文章及其参考文献。
大多数综述的研究都是回顾性的，因此不可能推断出因果关系。两项前瞻性研究发现产后 OCD 的发病率较高。这两项研究都是在土耳其和巴西进行的，因此可能在适用于其他文化群体方面存在局限性。
ppOCD 作为一种特定亚型的概念尚未得到充分证明。产后 OCD 更为普遍的证据是混杂的。产后 OCD 表现出独特的临床特征，具有特定的症状和病程，这一证据更具说服力。鉴于文化和宗教对 OCD 表现的影响，有必要开展协作性、国际性、前瞻性研究，以考虑到本综述中提出的方法学和定义问题，从而提供明确的结论。
