To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Evaluate durability of pregabalin's effect on pain associated with fibromyalgia (FM).
Randomized, double-blind, placebo-controlled trial with 1-week single-blind placebo run-in. Patients meeting ACR diagnostic criteria were randomized to pregabalin 300, 450, or 600 mg/d (BID) or placebo for 14 weeks (2-week dosage escalation; 12-week fixed-dosage). Pain was assessed with a daily pain diary using an 11-point numeric scale. Primary efficacy parameter was the LOCF endpoint mean pain score (MPS). Sensitivity analyses were assessed using the Duration Adjusted Average Change (DAAC) and a Mixed Model Repeated Measurements (MMRM).
745 randomized patients: 95% female, mean age=50 years, median FM duration=10 years, baseline MPS=6.7. Placebo-corrected differences in mean change from baseline to endpoint in MPS: 300mg/d, -0.71 (P=0.0009); 450mg/d, -0.98 (P<0.0001); 600mg/d, -1.00 (P<0.0001). Mean differences from placebo at endpoint (adjusted for treatment duration) over the entire treatment period (DAAC): 300mg/d, -.38, P=0.0200; 450mg/d, -.62; P=0.0001 and 600mg/d,-.57 P<0.0001. In the MMRM analysis, all 3 pregabalin treatment groups demonstrated pain relief by Week 1, and every weekly assessment thereafter, with the exception of 300mg/d treatment group at Week 11. Most common AEs: dizziness (all pregabalin, 35.8% vs placebo, 7.6%); somnolence (18.0% vs 3.8%). Most AEs were mild to moderate and resolved with continued treatment.
Pregabalin demonstrated significant reduction in endpoint MPS in FM patients. The DAAC sensitivity analysis confirmed the robustness of this effect. MMRM analyses demonstrated significant pain relief by Week 1 that was maintained throughout pregabalin treatment.
This study (A0081057) was designed to evaluate the long-term safety and efficacy of pregabalin treatment of fibromyalgia (FM).
In this 1-year, open-label (OL) extension of a 13-week randomized, placebo-controlled trial of pregabalin FM patients had the option of continuing pregabalin at doses of 150 to 600 mg/d. Efficacy was measured by the Short-Form McGill Pain Questionnaire (SF-MPQ), which included sensory and affective pain descriptors, Present Pain Intensity (PPI) index, and a Visual Analog Scale (VAS).
429 of 431 screened patients entered OL treatment, 249 (58%) completed, 70 (16.3%) discontinued due to an adverse event (AE), and 110 (25.7%) discontinued for other reasons. Median duration of treatment with pregabalin was 357 days (range, 1-402 days); 114 received pregabalin for ≥1 year. No clinically meaningful increases in dose were noted over the OL treatment period. Weighted mean dose was 414 mg/d in the first 3 months of treatment and 444 mg/d after 9 months of treatment. SF-MPQ sensory, affective, and total scores were improved relative to baseline, VAS pain score decreased 21 points (0-100 scale), and PPI decreased 0.9 point (0-5 scale). The most frequently reported all-causality AEs were dizziness, somnolence, peripheral edema, and increased weight, most of which were mild to moderate in intensity and of limited duration.
Pregabalin administered for up to 1 year was generally well tolerated by FM patients without evidence of dose increase over time. The sustained improvement in pain measures during OL treatment was consistent with that in shorter term double-blind trials.
Examine the evidence for a relationship between pregabalin effect on pain and baseline anxiety and depressive symptoms in patients with fibromyalgia (FM).
Chronic pain and concomitant anxiety and depressive symptoms are common in patients with FM, as well as in other chronic pain disorders. Pregabalin was effective for treating pain in FM patients in three parallel group RCTs (105, 1056, 1077) where data for anxiety and depressive symptom levels were collected.
Patients meeting ACR criteria for FM with a pain VAS score ≥40 mm were followed for 8-14 weeks in 3 randomized, double-blind, placebo-controlled trials. Patients (N=2022) received 150, 300, 450 or 600mg/d pregabalin or placebo. The primary efficacy parameter was change in endpoint Mean Pain Score (MPS) (range 0 [no pain]-10[worst possible pain]). Regression analyses evaluated whether changes in pain bore any relation to the baseline Hospital Anxiety and Depression Scales (HADS-A) and (HADS-D) levels.
Pregabalin 300, 450, and 600 mg/d, but not 150 mg/d, showed statistically significant improvements in pain compared with placebo (p<0.0001). For each pregabalin treatment group, improvements in pain at endpoint were not found to have a statistically significant association with baseline levels of anxiety or depressive symptoms. Adverse events (AEs) were consistent with known side effects of pregabalin; dizziness and somnolence, mild to moderate in intensity, were the most frequently reported AEs for pregabalin patients.
Pregabalin treatment demonstrated significant improvements in pain regardless of baseline anxiety or depressive symptom levels for patients with FM.
The education and training of doctors specialising in Child and Adolescent Psychiatry (CAP) varies substantially across Europe. There is a paucity of information available about training quality. This prompted an initial training survey led by Dr E Barrett (2010) which was expanded upon by the CAP working group in the 2010 EFPT international forum in Dubrovnik to create ‘country reports’ for 2010–2011.
The objectives of this study were to collect information relating to key aspects of CAP training programmes in Europe in a systematic way in order to start a ‘Training Database’ that can be held centrally by the EFPT. Information will be added to the database every year following EFPT annual international meetings.
We aim to better understand the training structures in CAP across europe to help inform best practice standards for training.
A pro-forma word document was emailed to all EFPT CAP contacts: there were 20 contacts emailed.
So far we have a response rate of over 60% and we are continuing to collect and collate relevant data. This survey highlighted a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.
This survey highlights a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.
Sleep disturbance is prominent in fibromyalgia (FM). This 14-week, randomized, double-blind, placebo-controlled study, evaluated the effect of pregabalin on pain and sleep-related outcomes in FM.
Patients meeting ACR (FM) diagnostic criteria were randomized to pregabalin 300, 450, or 600mg/d (BID) or placebo for 14 weeks (A0081077). Primary efficacy parameter: LOCF endpoint mean pain score (MPS). At baseline and endpoint, patients completed the Medical Outcomes Sleep (MOS) Sleep Scale. Mean Sleep Quality scores (11-point numeric ratings) were derived from patient daily diaries.
745 randomized patients: 95% female, mean age=50 years, baseline MPS: 6.7. Placebo-corrected differences from baseline to endpoint in MPS were: 300mg/d, -0.71 (p=.0009); 450mg/d, -0.98 (p<.0001); 600mg/d, -1.00 (p<.0001). For MOS Sleep Disturbance, all 3 pregabalin groups demonstrated significant improvements versus placebo (300, 450, and 600 mg/d, -8.91 [p=.0006]; -10.63 [p<.0001]; and -14.93 [p<.0001], respectively). Similar improvements were seen in Sleep Quality (300, 450, and 600mg/d; 0.42, p=0.0030; 0.48, p=.0006; and 0.68, p<.0001 respectively) and MOS Sleep Adequacy (300, 450 and 600mg/d; 5.86, p=.0324; 7.89, p=.0036, and 11.16, p<.0001 respectively). Endpoint Mean Sleep Quality scores across all 3 treatment groups showed significant improvements (300, 450 and 600mg/d; -0.74, p=.0006, -1.12, and -1.35, both p<.0001 respectively). Most common AEs: dizziness (all pregabalin, 35.8% vs placebo, 7.6%); somnolence (18.0% vs 3.8%). Incidence of AEs appeared to be dose-related; most were mild to moderate.
Pregabalin treatment demonstrated significant improvements in pain and patient reported measures of sleep disturbance, adequacy, and quality.
• The European Federation of Psychiatric Trainees is an independent federation of psychiatric trainees associations. 37 Countries were represented at the annual Forum in 2011.
• A Child and Adolescent Psychiatry (CAP) Working Group meets at this annual forum to discuss issues of relevance to CAP trainees. At the 2009 meeting, the group reflected on difficulties in collecting data on training across Euro.
1. Ten item survey was was circulated to trainee representatives to the European Federation of Psychiatric Trainees who attended the annual Forum in 2009.
2. Following this pilot study, a much larger study was conducted from 2010–2011.
• EFPT survey: In 2009–2010 pilot survey - 27 countries responded.
• The EFPT CAP group expanded this in 2010–2011. This survey collected data from 34 countries, 28 of whom provided full data-sets in the following domains:
○Structure and organisation of training;
○Training quality and content; and
○Working conditions and recruitment.
○Statistical analysis was performed on the data to achieve overall rankings of CAP training quality.
• This symposium will look at developing national and international surveys. Results from two completed EFPT CAP studies and ongoing work presented. These studies add significantly to extant literature- it is clear that training across Europe is extremely variable.
• This symposium will also highlight current opportunities for European Trainees. International collaborations and opportunities for trainees will be explored, and we will consider the role of trainees in international organisations
EFPT - The European Federation of Psychiatric Trainees is an independent federation of psychiatric trainees associations and its function is to provide a forum in which trainees can learn about the diversity of the current training of psychiatrists in Europe.
EFPT consists of several working groups that focus on supporting different fields (e.g. psychotherapy, child and adolescent psychiatry etc) and carry out various projects. The aim of CAP working group is firstly to represent CAP trainees and develop common recommendations regarding training while furthering links with organisations such as UEMS. In recent years the group has also recognised the need to collect information in order to assess the quality level of training in european countries, to recognise differences and build upon positives. In 2010–2011 this focused on training standards around Europe. In 2011–2012 we focus on:
A. The field of psychotherapy. The CAP group recognises that family relationships play a major role in the formation of a child's personality. The survey is being conducted in conjunction with the Psychotherapy WG within EFPT; thus training in this area in both adult psychiatry and CAP will be compared. Initial results will be presented at this symposium.
B. We believe that awareness of mental illness in the childhood should be an important part of the education in medical faculties. Therefore, we are keen to ascertain what placement opportunities in CAP are currently offered to medical students around Europe. Gathering information on this isT is our second aim for the next year.
The fetal membranes (FM) are comprised of the amniotic membrane (AM), chorionic membrane (CM), and underlying maternal decidua. Together they provide a barrier towards ascending infection and enable amniotic fluid (AF) homeostasis. Preterm premature rupture of the membranes (PPROM) can occur spontaneously and complicates around 2% of all pregnancies, leading to preterm birth, chorioamnionitis, neonatal sepsis, limb position defects, respiratory distress syndrome, pulmonary hypoplasia, and chronic lung disease. Membrane separation is a common finding after open fetal surgery that leads to iatrogenic PPROM (iPPROM) and intrauterine infection, complicating over 30% of fetal surgeries. The subsequent associated preterm birth compromises the outcome of treatment, reducing the clinical effectiveness of fetal surgery . Spontaneous healing of the membranes does not occur after fetoscopic surgery, leaving a visible defect in the FM (Figure 50.1) that is prone to AF leakage and subsequent iPPROM . To date, there are no clinical solutions to improve healing of the FM after they rupture.
Utilising routine surveillance data, this study presents a method for generating a baseline comparison that can be used in future foodborne outbreak investigations following a case–case methodology. Salmonella and Campylobacter cases (2012–2015) from Maricopa County, AZ were compared to determine differences in risk factors, symptoms and demographics. For foods and other risk factors, adjusted odds ratios were developed using Campylobacter as the reference. Comparisons were also made for three major Salmonella subtypes, Typhimurium, Enteritidis and Poona as compared with Campylobacter. Salmonella cases were younger, while Campylobacter cases were more Hispanic and female. Campylobacter cases reported consuming peppers, sprouts, poultry, queso fresco, eggs and raw nuts more and reported contact with animal products, birds, visiting a farm or dairy, owning a pet, a sick pet, swimming in a river, lake or pond, or handling multiple raw meats more. Salmonella cases reported visiting a petting zoo and contact with a reptile more. There were significant variations by Salmonella subtype in both foods and exposures. We recommend departments conduct this analysis to generate a baseline comparison and a running average of relevant odds ratios allowing staff to focus on trace-back of contaminated food items earlier in the outbreak investigation process.
Seven half-day regional listening sessions were held between December 2016 and April 2017 with groups of diverse stakeholders on the issues and potential solutions for herbicide-resistance management. The objective of the listening sessions was to connect with stakeholders and hear their challenges and recommendations for addressing herbicide resistance. The coordinating team hired Strategic Conservation Solutions, LLC, to facilitate all the sessions. They and the coordinating team used in-person meetings, teleconferences, and email to communicate and coordinate the activities leading up to each regional listening session. The agenda was the same across all sessions and included small-group discussions followed by reporting to the full group for discussion. The planning process was the same across all the sessions, although the selection of venue, time of day, and stakeholder participants differed to accommodate the differences among regions. The listening-session format required a great deal of work and flexibility on the part of the coordinating team and regional coordinators. Overall, the participant evaluations from the sessions were positive, with participants expressing appreciation that they were asked for their thoughts on the subject of herbicide resistance. This paper details the methods and processes used to conduct these regional listening sessions and provides an assessment of the strengths and limitations of those processes.
Herbicide resistance is ‘wicked’ in nature; therefore, results of the many educational efforts to encourage diversification of weed control practices in the United States have been mixed. It is clear that we do not sufficiently understand the totality of the grassroots obstacles, concerns, challenges, and specific solutions needed for varied crop production systems. Weed management issues and solutions vary with such variables as management styles, regions, cropping systems, and available or affordable technologies. Therefore, to help the weed science community better understand the needs and ideas of those directly dealing with herbicide resistance, seven half-day regional listening sessions were held across the United States between December 2016 and April 2017 with groups of diverse stakeholders on the issues and potential solutions for herbicide resistance management. The major goals of the sessions were to gain an understanding of stakeholders and their goals and concerns related to herbicide resistance management, to become familiar with regional differences, and to identify decision maker needs to address herbicide resistance. The messages shared by listening-session participants could be summarized by six themes: we need new herbicides; there is no need for more regulation; there is a need for more education, especially for others who were not present; diversity is hard; the agricultural economy makes it difficult to make changes; and we are aware of herbicide resistance but are managing it. The authors concluded that more work is needed to bring a community-wide, interdisciplinary approach to understanding the complexity of managing weeds within the context of the whole farm operation and for communicating the need to address herbicide resistance.
Fe is an essential nutrient for many bacteria, and Fe supplementation has been reported to affect the composition of the gut microbiota in both Fe-deficient and Fe-replete individuals outside pregnancy. This study examined whether the dose of Fe in pregnancy multivitamin supplements affects the overall composition of the gut microbiota in overweight and obese pregnant women in early pregnancy. Women participating in the SPRING study with a faecal sample obtained at 16 weeks’ gestation were included in this substudy. For each subject, the brand of multivitamin used was recorded. Faecal microbiome composition was assessed by 16S rRNA sequencing and analysed with the QIIME software suite. Dietary intake of Fe was assessed using a FFQ at 16 weeks’ gestation. Women were grouped as receiving low (<60 mg/d, n 94) or high (≥60 mg/d; n 65) Fe supplementation. The median supplementary Fe intake in the low group was 10 (interquartile range (IQR) 5–10) v. 60 (IQR 60–60) mg/d in the high group (P<0·001). Dietary Fe intake did not differ between the groups (10·0 (IQR 7·4–13·3) v. 9·8 (IQR 8·2–13·2) mg/d). Fe supplementation did not significantly affect the composition of the faecal microbiome at any taxonomic level. Network analysis showed that the gut microbiota in the low Fe supplementation group had a higher predominance of SCFA producers. Pregnancy multivitamin Fe content has a minor effect on the overall composition of the gut microbiota of overweight and obese pregnant women at 16 weeks’ gestation.
Infants with CHD are at increased risk of necrotising enterocolitis, which can interfere with the achievement of adequate nutrition and, ultimately, growth and development. Necrotising enterocolitis is classified by severity as suspected, confirmed, and advanced. We sought to quantify the incidence of all types of necrotising enterocolitis among infants who underwent surgery, with a particular focus on suspected necrotising enterocolitis. This is a retrospective review of all infants <6 months of age who underwent cardiac surgery during 2012 and 2013 at Children’s Hospital Colorado. We examined the hospital course of 265 hospitalisations (n=251 patients) and found 18 patients (19 hospitalisations) with suspected necrotising enterocolitis and 16 patients (16 hospitalisations) with confirmed or advanced necrotising enterocolitis. Single-ventricle physiology, lower weight, and younger age were associated with necrotising enterocolitis. Patients with all types of necrotising enterocolitis experienced prolonged length of hospital stay. We found suspected necrotising enterocolitis to be as common as confirmed necrotising enterocolitis, and it frequently occurred early in the post-operative course. We speculate that suspected necrotising enterocolitis may often be overlooked in research owing to a reliance on billing codes. Nevertheless, suspected necrotising enterocolitis poses a substantial barrier to post-operative progression of the CHD patient, as does confirmed necrotising enterocolitis. Following the diagnosis of all types of necrotising enterocolitis, there was wide variability in practice patterns. In response to this variability, we developed care guidelines for the diagnosis and treatment of necrotising enterocolitis in this population.
Deep inspiration breath hold (DIBH) is a method of motion management used in stereotactic ablative body radiotherapy (SABR) for lung tumours. An external gating block marker can be used as a tumour motion surrogate, however, inter-fraction gross target volume (GTV) displacement within DIBH occurs. This study measured this displacement during a reproducible breath hold regime. In addition, factors such as position of the gating block marker were analysed.
Methods and materials
A total of 121 cone beam computed tomography scans (CBCTs) from 22 patients who received DIBH SABR were retrospectively evaluated and the magnitude of inter-fraction GTV displacement was calculated for each fraction. This data was analysed to assess if any correlation existed between tumour displacement and variation in the gating block marker position on the patient, the amplitude of breath hold (BH) at computed tomography (CT), the amplitude of BH at treatment and the tumour location.
The measured tumour displacement was applied to the original planning CT to evaluate the dosimetric effect on surrounding organs at risk (OARs) using cumulative dose volume histograms (DVHs).
BH amplitude was reproducible within 0·13±0·1 cm (mean±standard deviation). The magnitude of tumour displacement within BH ranged from 0 to 1·52 cm (0·41±0·28 cm). Displacement in the superior-inferior, anterior-posterior and left-right planes were 0·31±0·26 cm, 0·16±0·18 cm and 0·07±0·12 cm, respectively. No statistically significant correlation was detected between tumour displacement within DIBH and the factors investigated. The range of variation in OAR dose was −7·0 to +3·6 Gy with one statistically significant increase in OAR dose observed (oesophagus mean dose increasing by 0·16 Gy).
Reproducible BH was achievable across a range of patients. Inter-fraction GTV displacement measured 0·41±0·28 cm. Due to this low level of motion, the correction of soft tissue moves did not adversely affect OAR dose.
No existing models of alcohol prevention concurrently adopt universal and selective approaches. This study aims to evaluate the first combined universal and selective approach to alcohol prevention.
A total of 26 Australian schools with 2190 students (mean age: 13.3 years) were randomized to receive: universal prevention (Climate Schools); selective prevention (Preventure); combined prevention (Climate Schools and Preventure; CAP); or health education as usual (control). Primary outcomes were alcohol use, binge drinking and alcohol-related harms at 6, 12 and 24 months.
Climate, Preventure and CAP students demonstrated significantly lower growth in their likelihood to drink and binge drink, relative to controls over 24 months. Preventure students displayed significantly lower growth in their likelihood to experience alcohol harms, relative to controls. While adolescents in both the CAP and Climate groups demonstrated slower growth in drinking compared with adolescents in the control group over the 2-year study period, CAP adolescents demonstrated faster growth in drinking compared with Climate adolescents.
Findings support universal, selective and combined approaches to alcohol prevention. Particularly novel are the findings of no advantage of the combined approach over universal or selective prevention alone.
Morphological responses of nonmammalian herbivores to external ecological drivers have not been quantified over extended timescales. Herbivorous nonavian dinosaurs are an ideal group to test for such responses, because they dominated terrestrial ecosystems for more than 155 Myr and included the largest herbivores that ever existed. The radiation of dinosaurs was punctuated by several ecologically important events, including extinctions at the Triassic/Jurassic (Tr/J) and Jurassic/Cretaceous (J/K) boundaries, the decline of cycadophytes, and the origin of angiosperms, all of which may have had profound consequences for herbivore communities. Here we present the first analysis of morphological and biomechanical disparity for sauropodomorph and ornithischian dinosaurs in order to investigate patterns of jaw shape and function through time. We find that morphological and biomechanical mandibular disparity are decoupled: mandibular shape disparity follows taxonomic diversity, with a steady increase through the Mesozoic. By contrast, biomechanical disparity builds to a peak in the Late Jurassic that corresponds to increased functional variation among sauropods. The reduction in biomechanical disparity following this peak coincides with the J/K extinction, the associated loss of sauropod and stegosaur diversity, and the decline of cycadophytes. We find no specific correspondence between biomechanical disparity and the proliferation of angiosperms. Continual ecological and functional replacement of pre-existing taxa accounts for disparity patterns through much of the Cretaceous, with the exception of several unique groups, such as psittacosaurids that are never replaced in their biomechanical or morphological profiles.
Serotonin is under-researched in attention deficit hyperactivity disorder (ADHD), despite accumulating evidence for its involvement in impulsiveness and the disorder. Serotonin further modulates temporal discounting (TD), which is typically abnormal in ADHD relative to healthy subjects, underpinned by reduced fronto-striato-limbic activation. This study tested whether a single acute dose of the selective serotonin reuptake inhibitor (SSRI) fluoxetine up-regulates and normalizes reduced fronto-striato-limbic neurofunctional activation in ADHD during TD.
Twelve boys with ADHD were scanned twice in a placebo-controlled randomized design under either fluoxetine (between 8 and 15 mg, titrated to weight) or placebo while performing an individually adjusted functional magnetic resonance imaging TD task. Twenty healthy controls were scanned once. Brain activation was compared in patients under either drug condition and compared to controls to test for normalization effects.
Repeated-measures whole-brain analysis in patients revealed significant up-regulation with fluoxetine in a large cluster comprising right inferior frontal cortex, insula, premotor cortex and basal ganglia, which further correlated trend-wise with TD performance, which was impaired relative to controls under placebo, but normalized under fluoxetine. Fluoxetine further down-regulated default mode areas of posterior cingulate and precuneus. Comparisons between controls and patients under either drug condition revealed normalization with fluoxetine in right premotor-insular-parietal activation, which was reduced in patients under placebo.
The findings show that a serotonin agonist up-regulates activation in typical ADHD dysfunctional areas in right inferior frontal cortex, insula and striatum as well as down-regulating default mode network regions in the context of impulsivity and TD.
Most empirical studies into the covariance structure of psychopathology have been confined to adults. This work is not developmentally informed as the meaning, age-of-onset, persistence and expression of disorders differ across the lifespan. This study investigates the underlying structure of adolescent psychopathology and associations between the psychopathological dimensions and sex and personality risk profiles for substance misuse and mental health problems.
This study analyzed data from 2175 adolescents aged 13.3 years. Five dimensional models were tested using confirmatory factor analysis and the external validity was examined using a multiple-indicators multiple-causes model.
A modified bifactor model, with three correlated specific factors (internalizing, externalizing, thought disorder) and one general psychopathology factor, provided the best fit to the data. Females reported higher mean levels of internalizing, and males reported higher mean levels of externalizing. No significant sex differences emerged in liability to thought disorder or general psychopathology. Liability to internalizing, externalizing, thought disorder and general psychopathology was characterized by a number of differences in personality profiles.
This study is the first to identify a bifactor model including a specific thought disorder factor. The findings highlight the utility of transdiagnostic treatment approaches and the importance of restructuring psychopathology in an empirically based manner.
Background: The cognitive-behavioural model of perinatal OCD suggests the role of increased sense of responsibility during the perinatal period in the development and maintenance of obsessive-compulsive symptoms. However, the idiosyncratic nature of responsibility attitudes and interpretations of intrusions is not fully understood. Aims: To investigate how responsibility interpretations regarding intrusions vary across the perinatal period and how this relates to obsessive-compulsive symptomatology. Method: 94 women (26 antenatal, 35 postpartum and 33 non-childbearing controls) completed measures of responsibility attitudes and interpretations regarding specific intrusions (either general or baby-related), as well as obsessive-compulsive symptomatology, anxiety and depression. Results: Postpartum ratings of responsibility interpretations regarding baby-related intrusions were significantly higher than: i) postpartum ratings of responsibility interpretations regarding non-baby intrusions; and ii) control group responsibility interpretations. The groups were not significantly different regarding general responsibility ratings. Ratings of baby-related responsibility interpretations predicted variance in obsessive-compulsive symptomatology. Conclusion: The postpartum group showed significant differences in responsibility interpretations regarding baby-related intrusions. These responsibility interpretations were shown to predict obsessive-compulsive symptomatology.