Obsessive-Compulsive Disorders in New Fathers: Feeling Out of Control

Abstract

In the early 2000s, Dr. Jonathan Abramowitz, a psychologist from the Mayo Clinic, was the first clinician to report four cases of paternal postpartum OCD. Obsessive-compulsive disorder during pregnancy or in the postpartum period in women has been previously reported with the most common occurrence of egodystonic intrusive thoughts that suddenly start to preoccupy a new mother’s mind. These thoughts are extraordinarily anxiety-provoking and usually result in a great deal of impairment in most domains of a woman’s life. The aetiology of such a disorder in the past was assigned to hormonal changes that occur either during pregnancy or in the postpartum period. The “serotonin hypothesis” suggested that the fluctuating levels of oestrogen and progesterone influenced the levels of serotonin which explained the onset of OCD. Therefore, OCD was earlier thought to be caused by serotonin dysfunction. As a result, little attention was paid to the occurrence of disturbing thoughts in males who do not go through the same hormonal fluctuations when their partner is either pregnant or postpartum. Rachman and colleagues suggested that obsessive-compulsive disorder is based on the understanding that most adults experience upsetting thoughts at some point. Some individuals respond to these thoughts in an unusual way by thinking that they may act upon them. This then becomes an increasingly pervasive fear and occupies their minds and controls their thoughts. Therefore, people with obsessional thoughts want to distract themselves by getting into compulsive rituals so that they can avoid thinking about these obsessive thoughts which are potentially threatening.