The impact of perinatal depression on the evolution of anxiety and obsessive-compulsive symptoms

Arch Womens Ment Health. 2015 Jun;18(3):457-61. doi: 10.1007/s00737-014-0476-x. Epub 2014 Oct 30.


We sought to examine the evolution of postpartum anxiety, obsessions and compulsions over time, and the influence of depression on their clinical course. This was a prospective cohort of obstetric patients enrolled at a tertiary care women's hospital. Women were recruited immediately postpartum and followed for 6 months. Women were screened for depression, state-trait anxiety, and obsessive-compulsive symptoms and dichotomized by the presence of depression. Four hundred sixty-one women agreed to participate in the study and completed the 2 weeks postpartum assessment; 331 (72 %) women completed the assessment at 6 months postpartum. At 2 weeks postpartum, 28 (19.9 %) women with depression had anxiety symptoms, compared to 4 (1.3 %) women who screened negative for depression (p < 0.001). Similarly, 36 (25.7 %) women with depression endorsed obsessions and compulsions compared to 19 (8.4 %) women without depression (p < 0.001). A significant interaction effect was present with anxiety over time such that by 6 months postpartum, there were no differences in symptoms in women with and without depression (p = 0.860). Conversely, the differences in obsessions and compulsions between depressed and non-depressed women persisted (p = 0.017). Women with postpartum depression are more likely to experience comorbid state-trait anxiety and obsessive-compulsive symptoms in the immediate postpartum period. While state-trait anxiety symptoms tend to resolve with time, obsessive-compulsive symptoms persist. Understanding these temporal trends is critical to tailor appropriate monitoring and treatment.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Depression / diagnosis*
  • Depression / psychology
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / psychology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Illinois / epidemiology
  • Obsessive-Compulsive Disorder / epidemiology*
  • Obsessive-Compulsive Disorder / psychology
  • Personality Assessment / statistics & numerical data*
  • Personality Inventory
  • Postpartum Period
  • Pregnancy
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Surveys and Questionnaires
  • Young Adult