The new study, titled, Obsessive-Compulsive Personality Disorder Symptoms As A Risk Factor For Postpartum Depressive Symptoms, was recently published in the Archives of Women’s Mental Health.
OCPD is defined as a relatively stable, pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control.
Study authors, Kiki van Broekhoven, Annemiek Karreman, Esther Hartman, Paul Lodder, Joyce Endendijk, Veerle Bergink, and Victor Pop were interested in this topic because from a vulnerability-stress model, coping with perinatal changes could be especially challenging for women who experience a strong need for control and predictability.
“First, we were interested in identifying various courses, or trajectories, of depressive symptoms during the postpartum period as postpartum depression is known to be a very heterogeneous disorder,” Pop told us. “Second, we were hoping to find out whether OCPD symptoms constitute a risk factor for depressive symptoms in postpartum women. Due to the known association between OCPD and depression, we hypothesized that higher levels of OCPD symptoms would be associated with trajectories of elevated depressive symptoms.”
As OCPD is one of the most common personality disorders in the general population, research into this topic is of great importance, say researchers.
“We feel it is important to look beyond the clinical diagnosis, however, as experiencing OCPD symptoms is likely to interfere with psychological well-being as well,” Pop told us. “As the perinatal period constitutes a timeframe of many changes and adaptations, expectant mothers with OCPD symptoms could be especially at risk to experience postpartum depressive symptoms.”
For the study, a cohort of 1427 women was followed from late pregnancy until 12 months postpartum. Trajectories of postpartum depressive symptoms were determined using growth mixture modelling with five repeated assessments (at 32 weeks pregnancy, six weeks postpartum and four, eight and 12 months postpartum). Next, the relationship between OCPD trait symptoms and these trajectories was examined through multinomial regression.
Three postpartum depressive symptom trajectories were identified: 1. Low symptoms (92%); 2. Increasing-decreasing symptoms (inverted u-shape) (5%); and 3. Increasing symptoms (3%). OCPD trait symptoms were associated with a higher likelihood of the trajectories 2 and 3, compared to reference trajectory 1, adjusted for age, educational level, unplanned pregnancy, previous depressive episode(s), and parity.
“The results were in line with our hypotheses,” Pop told us. “Up until now, however, OCPD had not been linked to trajectories of postpartum depressive symptoms, so we are excited to have found the first pieces of evidence for our theories.”
Pop and colleagues hope to gain increasing awareness of the importance of personality traits as part of a postpartum depression risk profile, beyond classical risk factors (such as a history of psychopathology).
“Our Pregnancy Obsessive-Compulsive Personality Disorder Symptom Checklist is a short, easy to administer self-report questionnaire for OCPD symptoms, which can be filled out during pregnancy,” Pop told us. “We feel that pregnancy would be the ideal time to start identifying OCPD trait symptoms, since women are regularly in contact with health professionals at this time.”
As the current study is among the first on this topic, Pop says future research should study the association between OCPD and postpartum depression more thoroughly by means of, for example, diagnostic interviews.
“We believe that health professionals involved in perinatal care should be aware of this rather ‘new class’ of vulnerable women,” Pop told us. “Detection of these women at risk during regular obstetric care is an important step in decreasing perinatal distress.”
Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group - Facebook Postpartum Depression & Anxiety Support Group - with over 1500 members worldwide. Blog: www.patriciatomasiblog.wordpress.com