Sichel D A, Cohen L S, Dimmock J A, Rosenbaum J F
Department of Psychiatry, Massachusetts General Hospital, Boston 02114.
J Clin Psychiatry. 1993 Apr;54(4):156-9.
The puerperium has typically been a period of risk for the development of psychiatric illness. Although postpartum depressive illness has been discussed extensively in the literature, obsessive compulsive disorder during pregnancy and puerperium has received little attention.
Fifteen women with new-onset obsessive compulsive symptoms during the puerperium were retrospectively evaluated by chart review; all met DSM-III-R criteria for obsessive compulsive disorder. Distinctive features of their clinical presentation, pharmacotherapy received, and status at 1-year follow-up were recorded.
Patients were noted to have a characteristic constellation of symptoms comprised of disabling intrusive obsessional thoughts to harm their babies. Obsessive rituals were not observed in any of the patients described. Patients frequently developed secondary depression and appeared to be exquisitely responsive to serotonin selective reuptake inhibitors.
The puerperium may be a period of risk for development of new-onset obsessive compulsive disorder. Clinicians caring for puerperal women need to be aware of the impact of these symptoms on maternal and fetal well-being.
产褥期通常是精神疾病发病的高危时期。尽管产后抑郁疾病在文献中已有广泛讨论，但孕期及产褥期的强迫症却很少受到关注。
通过病历回顾对15例在产褥期出现新发强迫症状的女性进行回顾性评估；所有患者均符合DSM-III-R强迫症标准。记录她们临床表现的显著特征、接受的药物治疗以及1年随访时的状况。
患者表现出一系列特征性症状，包括伤害婴儿的侵入性强迫观念，严重影响日常生活。在所描述的任何患者中均未观察到强迫仪式行为。患者常继发抑郁，且对5-羟色胺选择性再摄取抑制剂似乎极为敏感。
产褥期可能是新发强迫症的高危时期。照顾产妇的临床医生需要意识到这些症状对母婴健康的影响。
