Multiple small studies have demonstrated a link between infertility and psychological distress, reporting high rates of anxiety and depressive symptoms among women with infertility. These studies have evaluated psychiatric symptoms or psychological distress; however, less is known about the prevalence of more significant psychiatric disorders in this population.
Most women undergoing infertility treatment experience increased anxiety. In a randomized clinical trial, researchers explored the effectiveness of acupuncture in diminishing anxiety in a group of women undergoing IVF. 43 patients undergoing IVF received either active acupuncture (n=22) or sham treatment (n=21). Women with a history of psychiatric illness and those using antidepressants and/or anxiolytic drugs were excluded from the study. Anxiety levels were assessed before and after treatment using the Hamilton Anxiety Rating Scale (HAS).
Post-traumatic stress disorder (PTSD) occurs in approximately 10% of all women at some point in their lifetime. PTSD tends to occur more commonly in women during their childbearing years, yet we have only recently begun to look more closely at the incidence of PTSD associated with childbirth.
Given the prevalence of postpartum OCD and obsessive symptoms in women with postpartum depression, we should devote more time to this topic. This is an informative and well-written article by Alice Wolton on postpartum OCD in Forbes. In this piece, she mentions a recent study from Timpano and colleagues at the University of Miami where cognitive behavioral therapy (CBT) was used to prevent postpartum OCD.
In treating pregnant women with mood or anxiety disorders, we tend to focus primarily on the reproductive safety of psychotropic medications; however, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may carry some degree of risk. Untreated psychiatric illness in the mother cannot be considered a benign event, and a number of studies have indicated that depression during pregnancy may negatively affect pregnancy outcomes (reviewed in Bonari 2004).
