title: Stress response in postpartum women with and without obsessive-compulsive symptoms: an fMRI study.
abstract: BACKGROUND
  During the postpartum period, some women might be under a considerable amount of stress and at increased risk for on-set or exacerbation of obsessive-compulsive disorder (OCD). Little is known about the stress response correlates during the postpartum period and in patients with OCD. This study aimed to examine the cerebral, psychologic and endocrine correlates of the stress response in patients with OCD and during the postpartum period.
  
  
  METHODS
  Women with postpartum OCD, healthy postpartum women and healthy mothers past the postpartum period underwent functional magnetic resonance imaging while facing a reliable psychosocial stressor (the Montreal Imaging Stress Task). Stress-related psychologic and endocrine responses (i.e., cortisol) were obtained.
  
  
  RESULTS
  We enrolled 12 women with postpartum OCD, 16 healthy postpartum women and 11 healthy mothers past the postpartum period in our study. Compared with healthy postpartum counterparts, postpartum women with OCD had a heightened self-reported and endocrine stress response associated with a distinct brain activation pattern in response to psychosocial stress involving the orbitofrontal and temporal cortices. Moreover, compared with mothers assessed in a period of time beyond the postpartum period, healthy postpartum women did not differ in psychologic and cortisol response to stress, but recruited different brain regions, such as the dorsolateral prefrontal cortex and the anterior cingulate cortex, during exposure to stress.
  
  
  CONCLUSIONS
  Potential confounding factors, such as medication use, breastfeeding, parity and personality factors, may have modulated the stress-related endocrine response and could not be assessed in this study.
  
  
  CONCLUSIONS
  Obsessive-compulsive disorder and the postpartum period differentially influence the brain circuitry underlying psychosocial stress as well as the psychologic and endocrine responses.
authors: Women's Health Concerns Clinic, St. Joseph's Healthcare and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.
authors: Catherine
authors: C
authors: Lord
authors: Meir
authors: M
authors: Steiner
authors: Claudio N
authors: CN
authors: Soares
authors: Caitlin L
authors: CL
authors: Carew
authors: Geoffrey B
authors: GB
authors: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007091:Image Processing, Computer-Assisted; D008032:Limbic System / Q000502:physiology; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000378:metabolism / Q000523:psychology*; D010100:Oxygen / Q000097:blood; D049590:Postpartum Period / Q000378:metabolism / Q000523:psychology*; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology*; D055815:Young Adult
chemical_list: D010100:Oxygen; D006854:Hydrocortisone