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Hyperemesis and Threatened Abortion in Early Pregnancy: Relationship with Anxiety and Depression and Review of the Literature

Year 2015, Issue: 4, 202 - 209, 01.12.2015

Hüseyin Aksoy Ülkü Aksoy Yunus Hacımusalar Turgut Aydın Gökhan Açmaz Gülsüm Uysal Fulya Çağlı Mustafa Alparslan Babayiğit

Abstract

Objective: This study evaluated the current state of anxiety and depression levels in patients with HG and TA and compared the prevalence of anxiety and depression levels with healthy pregnant controls. The aim of this prospective casecontrol study was to investigate the possible relationship between anxiety, depression and HG and TA and compare the results with healthy pregnant controls. Patients and Methods: A prospective case–control study was performed at our tertiary referral centre. 84 consecutive women with HG and 88 consecutive women with TA constituted our study group and 98 healthy pregnant women constituted our control group. Beck Anxiety Inventory BAI and Beck Depression Inventory BDI were administered to patients during the psychiatric interview for the anxiety and depression evaluation. Results: The mean BAI scores in HG, TA and healthy control groups were 17.34 ± 8.97, 17.23 ± 8.71 and 7.03 ± 5.45, respectively. The mean BDI scores in HG, TA and healthy control groups were 15.54 ± 7.81, 16.27 ± 6.72 and 6.68 ± 5.28, respectively. Conclusion: The findings of this study indicated a potential link between HG, TA and anxiety and depression disorders. Therefore, patients with HG and TA during pregnancy should be evaluated in terms of anxiety and depression disorders as much as their medical conditions. Medical professionals should be sensitive to psychological consequences of HG and TA.

Keywords

anxiety depression hyperemesis pregnancy threatened abortion

References

  • Gadsby R, Barnie-Adshead AM, Jagger C. A prospective study of nausea and vomiting during pregnancy. Br J Gen Pract 1993;43:245–8.
  • Gazmararian JA, Petersen R, Jamieson DJ, Schild L, Adams MM, Deshpande AD, Franks AL. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol 2002;100:94–100.
  • Farrell T, Owen P. The significance of extrachorionic membrane separation in threatened miscarriage. Br J Obstet Gynaecol 1996;103:926–8.
  • Verberg MFG, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005;11:527–39.
  • Fairweather DV. Nausea and vomiting in pregnancy. Am J Obstet Gynecol 1968;102:135–75.
  • Weiss JL, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, et al. Threatened abortion: A risk factor for poor pregnancy outcome, a population- based screening study. Am J Obstet Gynecol 2004;190:745–50.
  • Swallow BL, Lindow SW, Masson EA, Hay DM. Psychological health in early pregnancy: relationship with nausea and vomiting. J Obstet Gynaecol 2004;24:28–32.
  • Köken G, Yilmazer M, Cosar E, Sahin FK, Cevrioglu S, Gecici O. Nausea and vomiting in early pregnancy: relationship with anxiety and depression. J Psychosom Obstet Gynaecol 2008;29:91–5.
  • Pirimoglu ZM, Guzelmeric K, Alpay B, Balcik O, Unal O, Turan MC. Psychological factors of hyperemesis gravidarum by using the SCL- 90-R questionnaire. Clin Exp Obstet Gynecol 2010;37:56–9.
  • Seng JS, Schrot JA, van De Ven C, Liberzon I. Service use data analysis of pre-pregnancy psychiatric and somatic diagnoses in women with hyperemesis gravidarum. J Psychosom Obstet Gynaecol 2007;28:209–17.
  • Tan PC, Vani S, Lim BK, Omar SZ. Anxiety and depression in hyperemesis gravidarum: prevalence, risk factors and correlation with clinical severity. Eur J Obstet Gynecol Reprod Biol 2010;149:153–8.
  • Uguz F, Gezginc K, Kayhan F, Cicek E, Kantarci AH. Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study. Gen Hosp Psychiatry 2012;34:398–402.
  • Annagür BB, Tazegül A, Gündüz S. Do psychiatric disorders continue during pregnancy in women with hyperemesis gravidarum: a prospective study. Gen Hosp Psychiatry 2013;35:492–6.
  • Bozzo P, Einarson TR, Koren G, Einarson A. Nausea and vomiting of pregnancy (NVP) and depression: cause or effect? Clin Invest Med 2011;34:E245.
  • Jahangiri F, Hirshfeld-Cytron J, Goldman K, Pavone ME, Gerber S, Klock SC. Correlation between depression, anxiety, and nausea and vomiting during pregnancy in an in vitro fertilization population: a pilot study. J Psychosom Obstet Gynaecol 2011;32:113–8.
  • Kramer J, Bowen A, Stewart N, Muhajarine N. NAUSEA and VOMITING of PREGNANCY : Prevalence , Severity and Relation. 2013;21–7.
  • Chou F-H, Lin L-L, Cooney AT, Walker LO, Riggs MW. Psychosocial factors related to nausea, vomiting, and fatigue in early pregnancy. J Nurs Scholarsh 2003;35:119–25.
  • Bozzo P, Koren G, Nava-Ocampo AA, Einarson A. The incidence of nausea and vomiting of pregnancy (NVP): a comparison between depressed women treated with antidepressants and non-depressed women. Clin Invest Med 2006;29:347–50.
  • Friedman T, Gath D. The psychiatric consequences of spontaneous abortion. Br J Psychiatry 1989;155:810–3.
  • Neugebauer R1, Kline J, Shrout P, Skodol A, O’Connor P, Geller PA, Stein Z, Susser M. Major depressive disorder in the 6 months after miscarriage. JAMA 1997;277:383–8.
  • Geller PA, Kerns D, Klier CM. Anxiety following miscarriage and the subsequent pregnancy: a review of the literature and future directions. J Psychosom Res 2004;56:35–45.
  • Lok IH, Neugebauer R. Psychological morbidity following
  • miscarriage. Best Pract Res Clin Obstet Gynaecol 2007;21:229–47.
  • Janssen HJ, Cuisinier MC, Hoogduin KA, de Graauw KP. Controlled prospective study on the mental health of women following pregnancy loss. Am J Psychiatry 1996;153:226–30.
  • Prettyman RJ, Cordle CJ, Cook GD. A three-month follow-up of psychological morbidity after early miscarriage. Br J Med Psychol 1993;66(Pt 4):363–72.
  • Seibel M, Graves WL. The psychological implications of spontaneous abortions. J Reprod Med 1980;25:161–5.
  • Chojenta C, Harris S, Reilly N, Forder P, Austin M-P, Loxton D. History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum. PLoS One 2014;9:e95038.
  • Coleman PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009. Br J Psychiatry 2011;199:180–6.
  • Craig M, Tata P, Regan L. Psychiatric morbidity among patients with recurrent miscarriage. J Psychosom Obstet Gynaecol 2002;23:157–64.
  • Uerpairojkit B, Charoenvidhya D, Tannirandorn Y, Wacharaprechanont T, Manotaya S, Samritpradit P, Somprasit C. Sonographic findings in clinically diagnosed threatened abortion. J Med Assoc Thai 2001;84:661–5.
  • Chung TK, Sahota DS, Lau TK, Mongelli JM, Spencer JA, Haines CJ. Threatened abortion: prediction of viability based on signs and symptoms. Aust N Z J Obstet Gynaecol 1999;39:443–7.
  • First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured clinical interview for DSM-IV clinical version (SCID-I/CV). DC: American Psychiatric Press, Washington DC.
  • Özkürkçügil A, Aydemir Ö, Yıldız M, Danacı E, Köroğlu E. Adaptation and reliability study of structured clinical interview for DSM-IV axis I disorders. İlaç ve Tedavi Dergisi 1999;12:233–6.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893–97.
  • Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother 1998;12:163–72.
  • Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years evaluation. Clin Psychol Rev 1988;8:77–100.
  • Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerlilik ve güvenilirliği. Türk Psikoloji Dergisi 1989;7:3–13.
  • Aydemir, Ö. ve Köroglu, E. Psikiyatride Kullanılan Klinik Ölçekler, Hekimler Yayın Birligi, Ankara, 2000;15-25.
  • Annagür BB, Kerimoğlu ÖS, Gündüz Ş, Tazegül A. Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women? J Obstet Gynaecol Res 2014;40:1009–14.
  • Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004;103:698–709.
  • Bödecs T, Szilágyi E, Cholnoky P, Sándor J, Gonda X, Rihmer Z, Horváth B. Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a Hungarian population-based sample. Psychiatr Danub 2013;25:352–8.
  • Tongsong T, Srisomboon J, Wanapirak C, Sirichotiyakul S, Pongsatha S, Polsrisuthikul T. Pregnancy outcome of threatened abortion with demonstrable fetal cardiac activity: a cohort study. J Obstet Gynaecol 1995;21:331–5.
  • Garel M, Blondel B, Lelong N, et al. Depressive reaction after miscarriage. Contracept Fertil Sex 1992;20:75–81.

ERKEN GEBELİKTE HİPEREMEZİS VE DÜŞÜK TEHTİDİ: ANKSİYETE VE DEPRESYON İLE İLİŞKİSİ VE LİTERATÜR TARAMASI

Year 2015, Issue: 4, 202 - 209, 01.12.2015

Hüseyin Aksoy Ülkü Aksoy Yunus Hacımusalar Turgut Aydın Gökhan Açmaz Gülsüm Uysal Fulya Çağlı Mustafa Alparslan Babayiğit

Abstract

Amaç: Bu çalışma hiperemezis HG ve düşük tehtidi Aİ olan hastaların mevcut anksiyete ve depresyon seviyelerini değerlendirmekte ve ayrıca anksiyete ve depresyon prevelanslarını sağlıklı gebe kontrolleri ile karşılaştımaktadır. Bu prospektif vaka-kontrol çalışmasının amacı anksiyete ve depresyon ile HG ve Aİ arasındaki olası ilişkiyi araştırmak ve bu sonuçları sağlıklı gebe kontrolleri ile karşılaştırmaktır. Hastalar ve Yöntemler: Bu prospektif vaka-kontrol çalışması üçüncü basamak referans hastenemizde gerçekleştirildi. Hiperemezisli 84 hasta ve düşük tehtidi olan 88 hasta çalışma grublarımız oluşturken; 98 sağlıklı gebe kadın ise kontrol grubumuzu oluşturdu. Hastalara anksiyete ve depresyon değerlendirmesi için psikiyatrik değerlendirme sırasında Beck Anksiyete Ölçeği BAI ve Beck Depresyon Ölçeği BDI uygulandı. Sonuçlar: Ortalama BAI skoru HG, Aİ ve sağlıklı kontrol grubunda sırasıyla 17.34 ± 8.97, 17.23 ± 8.71 ve 7.03 ± 5.45 idi. Ortalama BDI skoru HG, Aİ ve sağlıklı kontrol grubunda sırasıyla 15.54 ± 7.81, 16.27 ± 6.72 ve 6.68 ± 5.28 idi. Sonuç: Bu çalışmanın bulguları HG ve Aİ ile anksiyete ve depresyon arasında potansiyel bir bağlantı göstermektedir. Bu nedenle, gebelikte HG ve Aİ hastaları tıbbi durumları kadar anksiyete ve depresyon açısından da değerlendirilmelidirler. Klinisyenler HG ve Aİ’in psikolojik sonuçları konusunda duyarlı olmalıdırlar.

Keywords

anksiyet depresyon düşük tehtidi hiperemezis gebelik

References

  • Gadsby R, Barnie-Adshead AM, Jagger C. A prospective study of nausea and vomiting during pregnancy. Br J Gen Pract 1993;43:245–8.
  • Gazmararian JA, Petersen R, Jamieson DJ, Schild L, Adams MM, Deshpande AD, Franks AL. Hospitalizations during pregnancy among managed care enrollees. Obstet Gynecol 2002;100:94–100.
  • Farrell T, Owen P. The significance of extrachorionic membrane separation in threatened miscarriage. Br J Obstet Gynaecol 1996;103:926–8.
  • Verberg MFG, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005;11:527–39.
  • Fairweather DV. Nausea and vomiting in pregnancy. Am J Obstet Gynecol 1968;102:135–75.
  • Weiss JL, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, et al. Threatened abortion: A risk factor for poor pregnancy outcome, a population- based screening study. Am J Obstet Gynecol 2004;190:745–50.
  • Swallow BL, Lindow SW, Masson EA, Hay DM. Psychological health in early pregnancy: relationship with nausea and vomiting. J Obstet Gynaecol 2004;24:28–32.
  • Köken G, Yilmazer M, Cosar E, Sahin FK, Cevrioglu S, Gecici O. Nausea and vomiting in early pregnancy: relationship with anxiety and depression. J Psychosom Obstet Gynaecol 2008;29:91–5.
  • Pirimoglu ZM, Guzelmeric K, Alpay B, Balcik O, Unal O, Turan MC. Psychological factors of hyperemesis gravidarum by using the SCL- 90-R questionnaire. Clin Exp Obstet Gynecol 2010;37:56–9.
  • Seng JS, Schrot JA, van De Ven C, Liberzon I. Service use data analysis of pre-pregnancy psychiatric and somatic diagnoses in women with hyperemesis gravidarum. J Psychosom Obstet Gynaecol 2007;28:209–17.
  • Tan PC, Vani S, Lim BK, Omar SZ. Anxiety and depression in hyperemesis gravidarum: prevalence, risk factors and correlation with clinical severity. Eur J Obstet Gynecol Reprod Biol 2010;149:153–8.
  • Uguz F, Gezginc K, Kayhan F, Cicek E, Kantarci AH. Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study. Gen Hosp Psychiatry 2012;34:398–402.
  • Annagür BB, Tazegül A, Gündüz S. Do psychiatric disorders continue during pregnancy in women with hyperemesis gravidarum: a prospective study. Gen Hosp Psychiatry 2013;35:492–6.
  • Bozzo P, Einarson TR, Koren G, Einarson A. Nausea and vomiting of pregnancy (NVP) and depression: cause or effect? Clin Invest Med 2011;34:E245.
  • Jahangiri F, Hirshfeld-Cytron J, Goldman K, Pavone ME, Gerber S, Klock SC. Correlation between depression, anxiety, and nausea and vomiting during pregnancy in an in vitro fertilization population: a pilot study. J Psychosom Obstet Gynaecol 2011;32:113–8.
  • Kramer J, Bowen A, Stewart N, Muhajarine N. NAUSEA and VOMITING of PREGNANCY : Prevalence , Severity and Relation. 2013;21–7.
  • Chou F-H, Lin L-L, Cooney AT, Walker LO, Riggs MW. Psychosocial factors related to nausea, vomiting, and fatigue in early pregnancy. J Nurs Scholarsh 2003;35:119–25.
  • Bozzo P, Koren G, Nava-Ocampo AA, Einarson A. The incidence of nausea and vomiting of pregnancy (NVP): a comparison between depressed women treated with antidepressants and non-depressed women. Clin Invest Med 2006;29:347–50.
  • Friedman T, Gath D. The psychiatric consequences of spontaneous abortion. Br J Psychiatry 1989;155:810–3.
  • Neugebauer R1, Kline J, Shrout P, Skodol A, O’Connor P, Geller PA, Stein Z, Susser M. Major depressive disorder in the 6 months after miscarriage. JAMA 1997;277:383–8.
  • Geller PA, Kerns D, Klier CM. Anxiety following miscarriage and the subsequent pregnancy: a review of the literature and future directions. J Psychosom Res 2004;56:35–45.
  • Lok IH, Neugebauer R. Psychological morbidity following
  • miscarriage. Best Pract Res Clin Obstet Gynaecol 2007;21:229–47.
  • Janssen HJ, Cuisinier MC, Hoogduin KA, de Graauw KP. Controlled prospective study on the mental health of women following pregnancy loss. Am J Psychiatry 1996;153:226–30.
  • Prettyman RJ, Cordle CJ, Cook GD. A three-month follow-up of psychological morbidity after early miscarriage. Br J Med Psychol 1993;66(Pt 4):363–72.
  • Seibel M, Graves WL. The psychological implications of spontaneous abortions. J Reprod Med 1980;25:161–5.
  • Chojenta C, Harris S, Reilly N, Forder P, Austin M-P, Loxton D. History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum. PLoS One 2014;9:e95038.
  • Coleman PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009. Br J Psychiatry 2011;199:180–6.
  • Craig M, Tata P, Regan L. Psychiatric morbidity among patients with recurrent miscarriage. J Psychosom Obstet Gynaecol 2002;23:157–64.
  • Uerpairojkit B, Charoenvidhya D, Tannirandorn Y, Wacharaprechanont T, Manotaya S, Samritpradit P, Somprasit C. Sonographic findings in clinically diagnosed threatened abortion. J Med Assoc Thai 2001;84:661–5.
  • Chung TK, Sahota DS, Lau TK, Mongelli JM, Spencer JA, Haines CJ. Threatened abortion: prediction of viability based on signs and symptoms. Aust N Z J Obstet Gynaecol 1999;39:443–7.
  • First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured clinical interview for DSM-IV clinical version (SCID-I/CV). DC: American Psychiatric Press, Washington DC.
  • Özkürkçügil A, Aydemir Ö, Yıldız M, Danacı E, Köroğlu E. Adaptation and reliability study of structured clinical interview for DSM-IV axis I disorders. İlaç ve Tedavi Dergisi 1999;12:233–6.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893–97.
  • Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother 1998;12:163–72.
  • Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years evaluation. Clin Psychol Rev 1988;8:77–100.
  • Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerlilik ve güvenilirliği. Türk Psikoloji Dergisi 1989;7:3–13.
  • Aydemir, Ö. ve Köroglu, E. Psikiyatride Kullanılan Klinik Ölçekler, Hekimler Yayın Birligi, Ankara, 2000;15-25.
  • Annagür BB, Kerimoğlu ÖS, Gündüz Ş, Tazegül A. Are there any differences in psychiatric symptoms and eating attitudes between pregnant women with hyperemesis gravidarum and healthy pregnant women? J Obstet Gynaecol Res 2014;40:1009–14.
  • Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004;103:698–709.
  • Bödecs T, Szilágyi E, Cholnoky P, Sándor J, Gonda X, Rihmer Z, Horváth B. Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a Hungarian population-based sample. Psychiatr Danub 2013;25:352–8.
  • Tongsong T, Srisomboon J, Wanapirak C, Sirichotiyakul S, Pongsatha S, Polsrisuthikul T. Pregnancy outcome of threatened abortion with demonstrable fetal cardiac activity: a cohort study. J Obstet Gynaecol 1995;21:331–5.
  • Garel M, Blondel B, Lelong N, et al. Depressive reaction after miscarriage. Contracept Fertil Sex 1992;20:75–81.
There are 43 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Hüseyin Aksoy

Ülkü Aksoy

Yunus Hacımusalar

Turgut Aydın

Gökhan Açmaz

Gülsüm Uysal

Fulya Çağlı

Mustafa Alparslan Babayiğit

Publication Date December 1, 2015
Published in Issue Year 2015Issue: 4

Cite

EndNote Aksoy H, Aksoy Ü, Hacımusalar Y, Aydın T, Açmaz G, Uysal G, Çağlı F, Babayiğit MA (December 1, 2015) ERKEN GEBELİKTE HİPEREMEZİS VE DÜŞÜK TEHTİDİ: ANKSİYETE VE DEPRESYON İLE İLİŞKİSİ VE LİTERATÜR TARAMASI. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 4 202–209.