What is the most likely diagnosis for a postpartum woman with excessive anxiety and obsessive behaviors regarding her baby's health?

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Differential Diagnosis

  • Single most likely diagnosis
    • Obsessive-Compulsive Disorder (OCD): The patient's excessive concern about contamination and harm to her baby, as evidenced by her behaviors such as wearing sterile gloves, showering before breastfeeding, and washing fruits and vegetables multiple times, are characteristic of OCD. The onset of these symptoms postpartum and the patient's anxiety also support this diagnosis.
  • Other Likely diagnoses
    • Postpartum Anxiety: The patient's anxiety and excessive worry about her baby's health and safety, as well as her lack of sleep, could be indicative of postpartum anxiety.
    • Postpartum Obsessive-Compulsive Symptoms: This is a specific condition where women experience OCD symptoms postpartum, which may be related to hormonal changes and the stress of caring for a new baby.
  • Do Not Miss
    • Postpartum Depression (PPD) with anxious features: Although the patient does not report suicidal ideation, PPD can present with anxiety and obsessive thoughts, and it is essential to consider this diagnosis due to its potential severity and impact on both the mother and the baby.
    • Postpartum Psychosis: Although less likely, postpartum psychosis is a medical emergency that requires immediate attention. The patient's behavior, although excessive, does not seem to be psychotic, but it is crucial to rule out this diagnosis.
  • Rare diagnoses
    • Generalized Anxiety Disorder: While the patient's anxiety is evident, her symptoms seem more focused on specific concerns (contamination, harm to the baby) rather than the broad, generalized worry characteristic of generalized anxiety disorder.
    • Hypochondriasis: The patient's excessive concern about her baby's health could be indicative of hypochondriasis, but her symptoms seem more focused on contamination and prevention rather than fear of illness itself.

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