Abstract
The request for a psychiatric examination of patients with hyperemesis gravidarum (HG) is a unique challenge for the psychiatric consultant. Unfortunately, there are little data in the psychosomatic medicine literature to guide diagnostic evaluations and treatment of patients with HG. In this article, we summarize the existing literature and propose a practical approach to such patients based on the literature and our clinical experience.
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American College of Obstetrics and Gynecology (2004) ACOG (american college of obstetrics and gynecology) practice bulletin: Nausea and vomiting of pregnancy. Obstet Gynecol 103(4):803–814
Bahna SL, Bjerkedal T (1974) The course and outcome of pregnancy in women with neuroses. Acta Obstet Gynecol Scand 53(2):129–133
Broussard CN, Richter JE (1998) Nausea and vomiting of pregnancy. Gastroenterol Clin North Am 27(1):123–151
Depue RH, Bernstein L, Ross RK, Judd HL, Henderson BE (1987) Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: A seroepidemiologic study. Am J Obstet Gynecol 156(5):1137–1141
el-Mallakh RS, Liebowitz NR, Hale MS (1990) Hyperemesis gravidarum as conversion disorder. J Nerv Ment Dis 178(10):655–659
Fairweather DV (1968) Nausea and vomiting in pregnancy. Am J Obstet Gynecol 102(1):135–175
Fejzo MS, Ingles SA, Wilson M, Wang W, MacGibbon K, Romero R et al (2008) High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals. Eur J Obstet Gynecol Reprod Biol 141(1):13–17
Fell DB, Dodds L, Joseph KS, Allen VM, Butler B (2006) Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstet Gynecol 107(2 Pt 1):277–284
Goodwin TM, Montoro M, Mestman JH, Pekary AE, Hershman JM (1992) The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. J Clin Endocrinol Metab 75(5):1333–1337
Guclu S, Gol M, Dogan E, Saygili U (2005) Mirtazapine use in resistant hyperemesis gravidarum: Report of three cases and review of the literature. Arch Gynecol Obstet 272(4):298–300
HARVEY WA, SHERFEY MJ (1954) Vomiting in pregnancy; a psychiatric study. Psychosom Med 16(1):1–9
Heazell A, Thorneycroft J, Walton V, Etherington I (2006) Acupressure for the in-patient treatment of nausea and vomiting in early pregnancy: A randomized control trial. Am J Obstet Gynecol 194(3):815–820
Hod M, Orvieto R, Kaplan B, Friedman S, Ovadia J (1994) Hyperemesis gravidarum. A review. J Reprod Med 39(8):605–612
Iatrakis GM, Sakellaropoulos GG, Kourkoubas AH, Kabounia SE (1988) Vomiting and nausea in the first 12 weeks of pregnancy. Psychother Psychosom 49(1):22–24
Jewell, D., & Young, G. (2002). Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews (Online), (1)(1), CD000145.
Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C et al (2002) Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol 99(2):223–228
Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A (2002) Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 186(5 Suppl Understanding):S228–31
Lacasse A, Rey E, Ferreira E, Morin C, Berard A (2008) Validity of a modified pregnancy-unique quantification of emesis and nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am J Obstet Gynecol 198(1):71.e1–71.e7
Majerus PW, Guze SB, Delong WB, Robins E (1960) Psychologic factors and psychiatric disease in hyperemesis gravidarum: A follow-up study of 69 vomiters and 66 controls. Am J Psychiatry 117:421–428
Martin IC (1974) Confused and confusing-hyperemsis gravidarum. Nursing Times 70(13):473–474
Mazzotta P, Stewart D, Atanackovic G, Koren G, Magee LA (2000) Psychosocial morbidity among women with nausea and vomiting of pregnancy: Prevalence and association with anti-emetic therapy. J Psychosom Obstet Gynaecol 21(3):129–136
Meighan M, Wood AF (2005) The impact of hyperemesis gravidarum on maternal role assumption. Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN / NAACOG 34(2):172–179
Munch S (2000) A qualitative analysis of physician humanism: Women’s experiences with hyperemesis gravidarum. Journal of Perinatology : Official Journal of the California Perinatal Association 20(8 Pt 1):540–547
Munch S (2002b) Chicken or the egg? the biological-psychological controversy surrounding hyperemesis gravidarum. Social Science & Medicine (1982) 55(7):1267–1278
Munch S (2002a) Women’s experiences with a pregnancy complication: Causal explanations of hyperemesis gravidarum. Soc Work Health Care 36(1):59–76
Munch S, Schmitz MF (2006) Hyperemesis gravidarum and patient satisfaction: A path model of patients’ perceptions of the patient-physician relationship. J Psychosom Obstet Gynaecol 27(1):49–57
Poursharif B, Korst LM, Fejzo MS, MacGibbon KW, Romero R, Goodwin TM (2008) The psychosocial burden of hyperemesis gravidarum. Journal of Perinatology : Official Journal of the California Perinatal Association 28(3):176–181
Poursharif B, Korst LM, Macgibbon KW, Fejzo MS, Romero R, Goodwin TM (2007) Elective pregnancy termination in a large cohort of women with hyperemesis gravidarum. Contraception 76(6):451–455
Rohde A, Dembinski J, Dorn C (2003) Mirtazapine (remergil) for treatment resistant hyperemesis gravidarum: Rescue of a twin pregnancy. Arch Gynecol Obstet 268(3):219–221
Safari HR, Fassett MJ, Souter IC, Alsulyman OM, Goodwin TM (1998) The efficacy of methylprednisolone in the treatment of hyperemesis gravidarum: A randomized, double-blind, controlled study. Am J Obstet Gynecol 179(4):921–924
Schiff MA, Reed SD, Daling JR (2004) The sex ratio of pregnancies complicated by hospitalisation for hyperemesis gravidarum. BJOG : An International Journal of Obstetrics and Gynaecology 111(1):27–30
Seng JS, Oakley DJ, Sampselle CM, Killion C, Graham-Bermann S, Liberzon I (2001) Posttraumatic stress disorder and pregnancy complications. Obstet Gynecol 97(1):17–22
Simpson SW, Goodwin TM, Robins SB, Rizzo AA, Howes RA, Buckwalter DK et al (2001) Psychological factors and hyperemesis gravidarum. Journal of Women’s Health & Gender-Based Medicine 10(5):471–477
Slavney PR (1999) Diagnosing demoralization in consultation psychiatry. Psychosomatics 40(4):325–329
Soltani H, Taylor GM (2003) Changing attitudes and perceptions to hyperemesis gravidarum. RCM Midwives : The Official Journal of the Royal College of Midwives 6(12):520–524
Swallow BL, Lindow SW, Masson EA, Hay DM (2004) Psychological health in early pregnancy: Relationship with nausea and vomiting. Journal of Obstetrics and Gynaecology : The Journal of the Institute of Obstetrics and Gynaecology 24(1):28–32
Tsang IS, Katz VL, Wells SD (1996) Maternal and fetal outcomes in hyperemesis gravidarum. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics 55(3):231–235
Tsoi PT, Chin RK, Chang AM (1988) Psychogenic factors in hyperemesis gravidarum. Asia-Oceania Journal of Obstetrics and Gynaecology / AOFOG 14(4):457–460
Vasconcelos MS, Sampaio AS, Hounie AG, Akkerman F, Curi M, Lopes AC et al (2007) Prenatal, perinatal, and postnatal risk factors in obsessive-compulsive disorder. Biol Psychiatry 61(3):301–307
Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG (2005) Hyperemesis gravidarum, a literature review. Human Reproduction Update 11(5):527–539
Vutyavanich T, Kraisarin T, Ruangsri R (2001) Ginger for nausea and vomiting in pregnancy: Randomized, double-masked, placebo-controlled trial. Obstet Gynecol 97(4):577–582
Yoshimura M, Hershman JM (1995) Thyrotropic action of human chorionic gonadotropin. Thyroid : Official Journal of the American Thyroid Association 5(5):425–434
Yost NP, McIntire DD, Wians FH Jr, Ramin SM, Balko JA, Leveno KJ (2003) A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy. Obstet Gynecol 102(6):1250–1254
Zechnich R, Hammer T (1982) Brief psychotherapy for hyepremesis gravidarum. Am Fam Physician 26(5):179–181
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Kim, D.R., Connolly, K.R., Cristancho, P. et al. Psychiatric consultation of patients with hyperemesis gravidarum. Arch Womens Ment Health 12, 61–67 (2009). https://doi.org/10.1007/s00737-009-0064-7
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DOI: https://doi.org/10.1007/s00737-009-0064-7