Obsessive-compulsive symptoms, intrusive thoughts and depressive symptoms: a longitudinal study examining relation to maternal responsiveness

ABSTRACT

Background

The postpartum period is a vulnerable time for the development of depression. While perinatal depression has been well studied, intrusive thoughts related to the infant and classic obsessive-compulsive (OC) symptoms (e.g. chequering, ordering and cleaning) are also common in the postpartum and less well understood.

Objective

The present study investigated the associations among depressive symptoms, intrusive thoughts, and OC symptoms and their relation to the quality of the mother–infant relationship, particularly in the realm of maternal responsiveness.

Methods

Participants (N = 228) were recruited after delivery from a large Midwestern academic medical centre. At 2 and 12-week postpartum, participants completed self-report questionnaires that assessed demographics, depressive and OC symptoms, postpartum-specific intrusive thoughts and accompanying neutralising strategies, and maternal responsiveness.

Results

At 12-week postpartum, maternal responsiveness was significantly lower for participants that endorsed intrusive thoughts, neutralising strategies or OC symptoms of clinical significance. More severe intrusive thoughts and neutralising strategies were associated with maternal responsiveness but not predictive after accounting for depressive symptoms; depressive symptoms were associated with lower levels of maternal responsiveness across the postpartum.

Conclusions

A sizable number of postpartum women experience clinically significant postpartum-specific intrusive thoughts and utilise neutralising strategies, especially in the context of postpartum depressive symptoms. Depressive symptoms have the most influence on maternal responsiveness but it is also important to target intrusive thoughts and OC symptoms in the context of postpartum depression to promote the welfare of new mothers and their offspring.

KEYWORDS:

• Postpartum depression
• obsessive-compulsive symptoms
• intrusive thoughts
• postpartum anxiety
• women’s mental health

Highlights

• The perinatal period is a vulnerable time for obsessive-compulsive symptoms (OCS)

• Postpartum-specific intrusive thoughts can cause distress for some women

• Maternal responsiveness measures timely responsiveness to an infant’s signals

• More severe intrusive thoughts and OC symptoms are associated with less responsiveness

• More severe depressive symptoms predict less responsiveness

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Research reported in this publication was supported by the National Centre For Advancing Translational Sciences of the National Institutes of Health under Award Number U54TR001356. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health; National Centre for Advancing Translational Sciences [U54TR001356].