A Case of Postpartum Obsessive-Compulsive Disorder in a First-Time Father

Abstract

Obsessive-Compulsive Disorder (OCD) is a well-recognized psychiatric condition characterized by distressing obsessions and compulsions. While the perinatal period is a known trigger for OCD in women, less attention has been given to its occurrence in men, particularly new fathers. This case report examines the unique presentation of postpartum-onset OCD (ppOCD) in a first-time father. A 33-year-old father presented eight months after the birth of his first child with distressing intrusive thoughts related to harming his eight-month-old daughter. These thoughts were ego-dystonic, causing significant distress, and led to a rapid deterioration in his mental health. Intrusive thoughts included a desire to leave his daughter in a busy street and place her in a hot oven. The patient became severely depressed, experienced significant weight loss, and was unable to perform daily activities of living. He repeatedly denied any intent to act on these thoughts. Following a visit to the ED, the patient was admitted to a psychiatric facility and started on escitalopram and aripiprazole. Approximately one month post-discharge, the patient reported significant symptom improvement, and after two months, his symptoms were well-controlled. He was successfully tapered off aripiprazole due to remission of symptoms and adverse effects. This case report highlights the need for greater awareness and screening of ppOCD in both men and women during the perinatal period. Utilizing existing screening tools and well-established pharmacological treatments for OCD can significantly improve the recognition and management of this distressing disorder in fathers, ultimately improving their quality of life and that of their families. Further research is needed to better understand the prevalence and specific management of male ppOCD.