High Prevalence and Incidence of Obsessive-Compulsive Disorder Among Women Across Pregnancy and the Postpartum


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When screening for perinatal OCD, do you ask infant-specific questions? If not, patients may not make the connection to their symptoms. Learn more in this journal CME article.

Learning Objective

Provide effective screening and assessment for perinatal obsessive-compulsive disorder

Target Audience



Objective: During the perinatal period, women are at an increased risk for the onset/exacerbation of obsessive-compulsive disorder (OCD) and may experience perinatal-specific obsessions and/or compulsions. Past research has provided preliminary findings regarding the prevalence of OCD in the perinatal period but has often reported limited metrics and ignored perinatal specific symptoms. This research aimed to assess the prevalence and incidence of maternal OCD between the third trimester in pregnancy and 6 months postpartum.

Methods: An unselected sample of 763 English-speaking pregnant women and new mothers participated in a longitudinal, province-wide study between their third trimester in pregnancy and 9 months postpartum. They completed 3 online questionnaires and interviews (data collected between February 9, 2014, and February 14, 2017) and were administered a diagnostic interview to determine OCD status based on DSM-5 diagnostic criteria.

Results: A weighted prenatal period prevalence of 7.8% and a postpartum period prevalence of 16.9% were found. The average, prenatal, point prevalence estimate was 2.9%, and the average, postpartum, point prevalence estimate was 7.0%. Point prevalence gradually increased over the course of pregnancy and the early postpartum, attaining a peak of close to 9% at approximately 8 weeks postpartum, with a gradual decline thereafter. The cumulative incidence of new OCD diagnoses was estimated at 9% by 6 months postpartum.

Conclusions: Our study suggests that when women are encouraged to report their perinatal-specific symptoms, and current diagnostic criteria are applied, estimates for perinatal OCD may be higher than previously believed.

To cite: Fairbrother N, Collardeau F, Albert AYK, et al. High prevalence and incidence of obsessive-compulsive disorder among women across pregnancy and the postpartum. J Clin Psychiatry. 2021;82(2):20m13398.

To share: https://doi.org/10.4088/JCP.20m13398

Read the whole article at psychiatrist.com here:
High Prevalence and Incidence of Obsessive-Compulsive Disorder Among Women Across Pregnancy and the Postpartum

© Copyright 2021 Physicians Postgraduate Press, Inc.

Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
Activity expires: 

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.

CME Objective

After studying this article, you should be able to:

  • Provide effective screening and assessment for perinatal obsessive-compulsive disorder

Statement of Need and Purpose

Perinatal OCD, often associated with thoughts of infant harm, causes significant distress. Misdiagnosis can lead not only to inappropriate treatment but also, potentially, to unnecessary involvement of child protective services. Clinicians need greater awareness of the incidence and prevalence of perinatal OCD and education about how to screen for it.

Release, Expiration, and Review Dates

This educational activity was published in March 2021 and is eligible for AMA PRA Category 1 Credit™ through April 30, 2023. The latest review of this material was March 2021.

Disclosure of Off-Label Usage

The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.


This work was funded by an Operating Grant from the Canadian Institutes of Health Research (CIHR), Ottawa, Canada.

Role of the Sponsor

The funding agency (CIHR) reviewed the proposed research in full, prior to funding approval. The funding agency had no further role in the conduct of the study.

Previous presentation

Data from this study on the prevalence and incidence of perinatal OCD were presented at the Canadian Psychological Association’s 2020 Annual National Convention; Montréal, Canada; May 28–30, 2020 (in-person convention cancelled due to COVID-19; may be delivered in online format).


The authors thank the study interviewers: Melanie Bennett, BA, University of Victoria; Erinn Doncaster, BSW, University of Victoria; Madeline Nealis, MPH, University of Colorado Boulder; and Sheila Paoli, MA. Each have no conflicts of interest to declare.

Faculty Affiliation

Nichole Fairbrother, PhD*
Department of Psychiatry/Island Medical Program, University of British Columbia, Victoria, Canada

Fanie Collardeau, MSc
Department of Psychology, University of Victoria, Victoria, Canada

Arianne Y. K. Albert, PhD
Women’s Health Research Institute, BC Women’s Hospital & Health Centre, Vancouver, Canada

Fiona L. Challacombe, PhD
Department of Health Service and Population Research, King’s College London, London, United Kingdom

Dana S. Thordarson, PhD
Department of Family Practice, University of British Columbia, Vancouver, Canada

Sheila R. Woody, PhD
Department of Psychology, University of British Columbia, Vancouver, Canada

Patricia A. Janssen, PhD
School of Population and Public Health, University of British Columbia, Vancouver, Canada

*Corresponding author: Nichole Fairbrother, PhD, Room 002, Pearkes Bldg, Queen Alexandra Centre for Children’s Health, 2400 Arbutus Rd, Victoria, BC V8N 1V7, Canada (nicholef@uvic.ca).

Financial Disclosure

All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief of The Journal of Clinical Psychiatry, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; has been a member of the Steering Committee for Educational Activities for Medscape; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships.

The authors declare no potential conflicts of interest.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation


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