Psychopharmacology and Psychiatry Updates Distinguishing Postpartum OCD from Psychosis
Dec 2, 2025
Dr. Lauren Osborne, a perinatal psychiatrist from Weill Cornell Medicine, unpacks the complexities of postpartum OCD versus postpartum psychosis. She reveals that while intrusive thoughts about infant harm are common in OCD, they indicate serious risks in psychosis. The conversation includes effective ways to ask mothers about these thoughts safely and highlights key diagnostic differences. Dr. Osborne emphasizes the importance of accurate diagnosis for proper treatment and safety, providing insights into effective therapies for both disorders.
AI Snips
Chapters
Transcript
Episode notes
Stairs Case Illustrates Intrusive Thoughts
- A new mother refused to carry her baby near stairs after terrifying images of dropping the baby.
- She was horrified by the thoughts and feared they meant she posed a threat to her newborn.
Postpartum OCD Presents With Harm-Focused Intrusions
- Postpartum OCD commonly presents with intrusive thoughts about infant harm and avoidance or checking behaviors.
- Onset in postpartum often features harm-related obsessions rather than contamination themes seen in pregnancy-onset OCD.
Ask Directly Using Normalizing Language
- Ask directly and nonjudgmentally about thoughts of harming the baby using normalizing language.
- Say something like, “many women…experience scary intrusive thoughts…Has that ever happened to you?” to encourage disclosure.