Collardeau, FanieAnglin, Olivia L. U.Albert, ArianneMayhue, Jazlyn G.Fairbrother, Nichole2026-06-182026-06-182024Collardeau, F., Anglin, O. L. U., Albert, A., Mayhue, J. G., & Fairbrother, N. (2024). Prevalence and course of unwanted, intrusive thoughts of infant-related harm. The Journal of Clinical Psychiatry, 85(3), 23m15145. https://doi.org/10.4088/JCP.23m15145https://doi.org/10.4088/JCP.23m15145https://hdl.handle.net/1828/24001Objective: Unwanted, intrusive thoughts (UITs) of infant related harm are a common postpartum phenomenon and can be classified into thoughts of accidental harm (TAH) and thoughts of intentional harm (TIH). Our study’s objective was to complete a comprehensive, comparative analysis of TAH and TIH by commenting on their prevalence, course, characteristics (time, distress, impairment) and most intense period. Methods: 763 English-speaking pregnant women across British Columbia were recruited to participate in a prospective cohort study. Study data was collected between February 2014 and February 2017. UITs were assessed by semi-structured interviews twice during the postpartum period. Results: The prevalence of TAH and TIH in the postpartum period was 95.8% and 53.9%, respectively. The most common TAH included thoughts of the baby becoming apneic or dying from SIDS; the most common TIH included thoughts of neglect. On average, TAH are more prevalent, time consuming, and result in greater interference compared to TIH. The most intense period for TAH (5.74 weeks postpartum) and TIH (within first 8 weeks postpartum) was identified. During this period, over 40% of participants reported moderate or extreme distress related to UITs. For most, UITs decreased in frequency or completely resolved by 6 months postpartum and most participants did not report clinically significant symptoms. Conclusion: UITs are a normative and typically self-resolving occurrence in the postpartum period. UITs’ most intense period signifies a time of heightened vulnerability. Increased education is necessary to normalize and reduce distress associated with UITs.enPostprintDepartment of Psychology