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Pereira AT, Araújo A, Azevedo J, Marques CC, Soares MJ, Cabaços C, Marques M, Pereira D, Pato M, Macedo A. The Postpartum Obsessive-Compulsive Scale: Psychometric, Operative and Epidemiologic Study in a Portuguese Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10624. [PMID: 36078340 PMCID: PMC9517828 DOI: 10.3390/ijerph191710624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although obsessive-compulsive (OC) symptoms are common in the perinatal period, measures to comprehensively assess their presence, frequency, interference and severity are lacking. The Perinatal Obsessive-Compulsive Scale (POCS) is the only self-report questionnaire with context-specific items. It includes items to assess perinatal-specific obsessions and compulsions, a severity scale and an interference scale. OBJECTIVES (1) to analyze the validity and reliability of the Portuguese version of the POCS; (2) to find Obsessive-Compulsive Disorder (OCD) prevalence in postpartum and determine the POCS cut-off scores and its accuracy (sensitivity, specificity and predictive values) in screening for OCD according to DSM-5 criteria; (3) to describe the prevalence, content, severity, interference and onset of OC symptoms in the postpartum. METHODS 212 women in postpartum filled in a booklet, including the POCS Portuguese preliminary version, the Perinatal Anxiety Screening Scale and the Postpartum Depression Screening Scale; they were interviewed with the Diagnostic Interview for Psychological Distress-Postpartum. RESULTS Confirmatory Factor Analysis revealed that POCS presented acceptable fit indexes (χ2/df = 2.2971; CFI= 0.9319; GFI = 0.8574; TLI = 0.9127; RMSEA = 0.860, p < 0.001). The Cronbach's alphas were all > 0.800. The POCS cut-off point that maximized the Youden Index (J = 0.86, 95% CI [0.94-0.99]) was 20, corresponding to an Area Under the Curve of 0.970 (p < 0.001; Standard Error = 0.031; 95% CI: 0.937 to 0.988). The prevalence of postpartum OCD was 3.30%. The severity of thoughts and behaviors was moderate to severe for approximately 15% of women. For thirty-five percent of women, the onset of symptoms was in the first three months postpartum. CONCLUSIONS The Portuguese version of POCS has good validity, reliability and accuracy and may be considered ready for use in both clinic and research fields. POCS provides specific information regarding symptoms and individual patterns experienced by each woman, which allows normalization, destigmatization and personalized intervention.
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Affiliation(s)
- Ana Telma Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Ana Araújo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Julieta Azevedo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal
| | - Cristiana C. Marques
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal
| | - Maria João Soares
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Carolina Cabaços
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Mariana Marques
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal
| | - Daniela Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Michele Pato
- Keck School of Medicine of the University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, USA
| | - António Macedo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
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Blum S, Mack JT, Weise V, Kopp M, Asselmann E, Martini J, Garthus-Niegel S. The impact of postpartum obsessive-compulsive symptoms on child development and the mediating role of the parent-child relationship: A prospective longitudinal study. Front Psychiatry 2022; 13:886347. [PMID: 36203839 PMCID: PMC9532008 DOI: 10.3389/fpsyt.2022.886347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The first 2 years of life are a particularly sensitive period for the parent-child relationship as well as a healthy, age-appropriate child development. Both have been shown to be linked to postpartum depressive and anxiety symptoms, while the role of obsessive-compulsive symptoms, which are also common, is still largely understudied. In addition, fathers have been neglected in this area of research. This study, which includes both mothers and fathers, aims to investigate the longitudinal associations between postpartum obsessive-compulsive symptoms and different domains of child development, as well as the mediating role of the parent-child relationship. METHODS Data were drawn from the prospective longitudinal study DREAM, with 674 mothers and 442 fathers from the general population completing self-report questionnaires at four measurement points. Longitudinal associations between parental postpartum obsessive-compulsive symptoms 8 weeks postpartum, the parent-child relationship 14 months postpartum, and child development 24 months postpartum were investigated using regression and mediation analyses. A number of potential confounding variables were considered, i.e., age, academic degree, postpartum depressive and anxiety symptoms of the parents, preterm birth and temperament of the child, as well as COVID-19 pandemic-driven adversities. RESULTS When adjusting for confounders, neither maternal nor paternal postpartum obsessive-compulsive symptoms had adverse effects on the respective parent-child relationship and child development. Further, no mediating role of the parent-child relationship between parental postpartum obsessive-compulsive symptoms and child development could be confirmed. Instead, we found that the mother- and father-child relationship were differentially related to specific child developmental domains. For mothers, a poorer mother-child relationship was prospectively related to poorer fine motor development. For fathers, a poorer father-child relationship prospectively predicted a poorer overall development as well as poorer gross motor, fine motor, problem-solving, and personal-social development. CONCLUSION Our results suggest that negative effects on the parent-child relationship and child development may only become apparent in full-blown postpartum obsessive-compulsive disorder. Given the differential impact on specific developmental domains, our findings also suggest that it is crucial to consider both parents in clinical practice as well as in future research, rather than focusing only on the mother-child dyad.
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Affiliation(s)
- Sophie Blum
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Judith T Mack
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Victoria Weise
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Department of Psychology, HMU Health and Medical University, Potsdam, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Institute for Systems Medicine and Faculty of Medicine, Medical School Hamburg, Hamburg, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Fathers' Experience of Perinatal Obsessive-Compulsive Symptoms: A Systematic Literature Review. Clin Child Fam Psychol Rev 2021; 24:529-541. [PMID: 34046813 DOI: 10.1007/s10567-021-00348-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2021] [Indexed: 10/21/2022]
Abstract
Perinatal Obsessive-Compulsive Disorder (pOCD) refers to the onset/exacerbation of Obsessive-Compulsive Disorder (OCD) during the perinatal period. This disorder has been studied in mothers, with limited research conducted on fathers. The aim of the current study was to conduct the first systematic review of research investigating the experience of pOCD in fathers. A systematic review was conducted via electronic searches of Scopus, ProQuest, APA PsychNet, PubMed, and EBSCOhost. There were 523 articles identified and screened for eligibility, resulting in six eligible studies included in the final review. All studies reported the presence of subclinical obsessive-compulsive symptoms in fathers during the perinatal period, with the prevalence comparable to mothers. Compared to mothers, however, fathers were found to report less intrusion-related distress. Two studies reported a correlation between dysfunctional beliefs, negative appraisal of intrusions, and pOCD symptoms. Common categories of obsessive thoughts and compulsions experienced by fathers were also identified. Fathers appear susceptible to pOCD, which is consistent with the Cognitive-Behavioral Theory of OCD. Future research is recommended, therefore, to investigate clinical prevalence and severity of pOCD in fathers, particularly relative to mothers, and further investigate the role of dysfunctional beliefs in the development of pOCD.
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