, Volume 5, Issue 4, pp 129-149

Affective disorders in the aftermath of miscarriage: A comprehensive review

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We review the research literature regarding affective symptomatology and disorders following miscarriage, with an emphasis on controlled studies and those that have been published since the last review article in 1996. The current review draws a sharp distinction between controlled and uncontrolled designs and clarifies the proper inferences that may be drawn from each, as only with an appropriate comparison group can it be determined whether the affective reactions following miscarriage are a specific consequence of the reproductive loss or of other life events common in women of reproductive age. In addition to providing an update of the literature on depression in the aftermath of miscarriage and associated risk factors, we also discuss reproductive loss in the context of attachment theory and grief, and present information on topics that were not covered extensively (or at all) by prior reviews, such as issues related to a pregnancy subsequent to miscarriage and the impact of miscarriage on the partners of miscarrying women. In the final section, treatment options relevant to miscarriage are presented.

Accepted August 20, 2002; Published online October 30, 2002
Acknowledgement The authors wish to thank Richard Neugebauer, PhD, MPH for his helpful comments on earlier drafts of this manuscript, and Danielle Kerns for her assistance with the manuscript preparation. Dr. Klier was supported by a grant from the International Office of the University of Vienna.
Correspondence: Claudia M. Klier, MD, Department of Psychiatry, University of Vienna, General Hospital, Währingerguertel 18-20, A-1090 Vienna, Austria; e-mail: claudia.klier@univie.ac.at