Recommended Assessment and Treatment of Perinatal OCD

The increased prevalence, distinctive symptom presentation, and potentially unique impacts associated with OCD in the perinatal period (‘Perinatal OCD’ or ‘PnOCD’) indicates the need for considerations and specific guidelines to inform best-practice in working with new/expecting parents with OCD.

This 2023 study addresses the gap in the literature and is the first to collate and outline a set of clinical best practice recommendations for assessing, managing, and treating individuals with perinatal OCD and their families.

It is also intended to increase health practitioners’ understanding of this disorder and its treatment.

One hundred and two statements were endorsed for inclusion in the final set of recommendations for clinical best practice with perinatal OCD. These recommendations inform practice across eight themes:

  • Psychoeducation
  • Screening
  • Assessment
  • Differential diagnosis
  • Case care considerations
  • Treatment
  • Partners and families
  • Culture and diversity

Of note, eleven statements (10.8% of the 102 endorsed statements) were unanimously endorsed by all members of both consumer and professional panellists as ‘essential’ or ‘important’ to include as recommendations. These statements are:

  • General information provided to expectant and new parents about perinatal mental health and wellbeing should include PnOCD.
  • Psychoeducation should be provided to normalise that the perinatal period is one of significant life changes, that perinatal mental health concerns are common during this period, and that treatments are available.
  • People with a history of mood, anxiety or OCD symptoms should be routinely screened for PnOCD.
  • If a parent does not consent to pnOCD assessment, the health professional should document this, and they should be offered the opportunity to request an assessment in the future should they change their mind.
  • At the outset of an assessment of pnOCD symptoms, the parent should be provided with an explanation of the assessment, explaining the routine nature of the assessment and the limits of confidentiality, and provide their informed consent.
  • The parent should be allowed to decide who is present during the pnOCD assessment (alone, with significant others, with children etc.).
  • Health professionals should be mindful of the health and welfare of both the parent/s and the fetus/infant.
  • If the assessing clinician is unable to provide ongoing treatment, the individual should be referred for ongoing treatment with an appropriate mental health professional.
  • Care should be continued until the individual and treating professional both agree it is time to cease.
  • If the individual declines pnOCD treatment and there are no risk factors, parents should be provided with information regarding how to seek services in the future should they choose to.
  • Clinicians should be aware that psychological and pharmacotherapy treatment options exist for treating pnOCD, both with empirical evidence supporting their efficacy.

Please refer to the ‘List of endorsed statements for final recommendation’ for all endorsed statements