Postnatal intrusive thoughts and psychotic-like experiences: Exploring associations with parenting experiences and mental health

During the perinatal period, many parents experience mental health difficulties of varying severity, which have been associated with adverse outcomes. Examples include perinatal obsessive compulsive disorder (OCD) which can be thought to exist on a continuum from subclinical symptoms (e.g., intrusive thoughts (ITs)) to clinical diagnosis of OCD. Similarly postpartum psychosis can range from subclinical ‘psychotic like experiences’ (PLEs) to clinical diagnosis. These disorders are distinct conditions, yet some argue an overlap or comorbidity in symptoms, including co-occurrence postnatally, and they are therefore explored in tandem in this study. Limited literature explores these difficulties in community perinatal populations, and less is known about distress, or potential associations with parenting experiences. A cross-sectional, quantitative design was applied. Participants were parents in the postnatal period (12 months after birth); they completed an anonymous, online survey, exploring experiences of ITs, PLEs, parenting (perceived competence and stress) and mental health (depression, anxiety, and stress). Of 349 participants, 96% reported at least one IT, 90.8% reported associated distress and 95% engaged in behaviours to cope. Considering PLEs, 89% experienced at least one PLE, 88.8% reported associated distress and 30.4% could be considered ‘at-risk’ for developing psychosis. Distressing ITs and PLEs were significantly associated with lower perceived competence and satisfaction, increased parenting stress and mental health symptoms, although this relationship was indirectly mediated by depression and anxiety. Males reported more ITs, parenting stress, depression, anxiety, and lower perceived competence than females. More research is needed to better understand ITs and PLEs across and beyond the perinatal period.