Obsessive-compulsive disorder exacerbated during pregnancy: a case report.

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.