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Objective: Hyperemesis gravidarum (HG) affects 0.5–2% of pregnant women, and 10% of those diagnosed require at least one inpatient hospitalization. The pathogenesis of HG has not yet been clearly identified. Some endocrine factors such as human chorionic gonadotropin, estrogens, progesterone and thyroid hormone, gastrointestinal dysfunction, hepatic abnormalities, autonomic nervous dysfunction, and psychosomatic causes may play a role in this medical condition. Despite the common psychiatric symptoms observed in women with HG, in these subjects the psychiatric etiology is unclear. We aimed to determine Axis I psychiatric disorders in women with hyperemesis gravidarum (HG) and to follow up the course of psychiatric disorder and its association with nausea and vomiting during pregnancy.
Methods: The study sample was composed of 47 patients with HG. Psychiatric interviews were conducted using the Structured Clinical Interview for DSM-IV (SCID-I). Others psychiatric interviews were performed in the second and third trimesters. On each visit, the subjects completed the Beck Depression Inventory and the Beck Anxiety Inventory.
Results: The prevalence of any anxiety disorder was 25.5%, and the prevalence of any mood disorder was 14.9% in women with HG in the first trimester. Psychiatric disorders continued throughout the pregnancy in two thirds of the women, who had HG and a psychiatric diagnosis. Any SCID diagnosis in the first trimester was higher in women whose nausea and vomiting had partially resolved than in women whose nausea and vomiting had fully resolved (p<0.05).
Conclusion: The present studies suggest that psychiatric disorders might play a significant role in the etiology of HG. Our findings presented a potential connection between HG and anxiety disorders and major depressive disorder. Additionally, the nausea and vomiting symptoms in women with HG and a psychiatric disorder may persist during pregnancy.