Female reproductive cycle and obsessive-compulsive disorder.
BACKGROUND
The aim of our study was to assess whether there is a relationship between reproductive cycle events and the initiation or changes in symptoms of obsessive-compulsive disorder (OCD).


METHODS
Forty-six female outpatients meeting DSM-IV criteria for OCD completed a semistructured interview at our OCD unit to assess the relationship between reproductive cycle events and OCD. Dates of data collection were from January 2001 to December 2003.


RESULTS
In our sample, OCD onset occurred in the same year as menarche in 22% (N = 10), at pregnancy in 2% (N = 1), at postpartum in 7% (N = 3), and at menopause in 2% (N = 1). Worsening of preexisting OCD was reported by 20% of patients (9/45) at premenstruum, 8% (1/12) at pregnancy, 50% (6/12) at postpartum, and 8% (1/12) at menopause. The number of premenstrual mood symptoms, which included anxiety, irritability, mood lability and depressed mood, was associated with both premenstrual worsening of OCD (OR = 5.1, p < .01) and onset or worsening of OCD at postpartum (OR = 2.7, p < .05). Patients with an onset or worsening of OCD at postpartum also more frequently reported pre-menstrual worsening of OCD and previous history of major depressive disorder, including postpartum depression (p < or =.05 for all).


CONCLUSIONS
In a substantial number of patients, the onset or worsening of OCD was related to reproductive cycle events, especially at menarche and postpartum. Certain women with OCD seem to be vulnerable to worsening of OCD at different reproductive periods that imply hormonal fluctuations, and premenstruum and post-partum were the 2 reproductive events with a greater vulnerability. Those patients whose OCD symptoms appeared to be related to reproductive events also exhibited a greater history of mood symptoms (premenstrual depression and major depressive episodes).
Labad
Javier
J
Obsessive-Compulsive Disorder Clinical and Research Unit, Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Menchón
José Manuel
JM
Alonso
Pino
P
Segalàs
Cinto
C
Jiménez
Susana
S
Vallejo
Julio
J
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008572:Menarche / Q000523:psychology; D008593:Menopause / Q000523:psychology; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D011293:Premenstrual Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012098:Reproduction; D012720:Severity of Illness Index