Evidence Against a Link Between Hyperemesis Gravidarum and Personality Characteristics from an Ethnically Diverse Sample of Pregnant Women: A Pilot Study

Abstract

Background: Hyperemesis gravidarum (HG), a pregnancy-related condition marked by extreme nausea and vomiting, has been considered a psychosomatic illness associated with long-standing personality characteristics (e.g., hysteria). In this pilot study, we examined personality, somatic, and psychological variables with ethnically diverse samples of women with HG and women with typical levels of nausea and vomiting of pregnancy (NVP). Methods: Personality (Minnesota Multiphasic Personality Index-2 [MMPI-2] and MMPI-2RF), somatic (MMPI-2RF), and psychological (Beck Depression Inventory-II [BDI-II] and NVP-related quality of life) variables collected during the first trimester of pregnancy were compared between 15 women with HG and 15 women with normal levels of NVP matched for age, education, marital status, insurance source, and race=ethnicity. A secondary analysis was performed comparing these variables among a group of 9 asymptomatic pregnant women to the HG and NVP groups. Results: No significant differences were found between the HG and NVP groups on any personality, somatic, or psychological variables. Both groups had clinically significant elevations on the MMPI-2 hypochondriasis scale, which incorporates somatic symptoms. The NVP group had a clinically significant elevation on the MMPI-2RF gastrointestinal complaints scale. Both groups had significantly higher means on the MMPI-2 and MMPI-2RF scales than the asymptomatic group. Predominantly Spanish speakers appeared particularly vulnerable to psychological distress associated with somatic complaints. Conclusions: The results of this pilot study suggest that research with HG patients is feasible and that psychological distress expressed by women with HG and NVP may reflect reactions to somatic symptoms. No evidence was found to support an association between HG and personality characteristics. Recommendations for future research are provided, such as examining the potential benefits of translation services for Spanishspeaking HG patients.

Nausea and Vomiting in Early Pregnancy of Adolescents: Relationship with Depressive Symptoms

“…Although the relationship between HG and psychiatric disorders has been examined, no consensus on this issue has been reached. Despite the few studies showing that HG is not a risk factor for antenatal depression or other psychosomatic disorders (33)(34), the general view is that the risk for antenatal depression increases in females with NVP, particularly in severe cases, which is consistent with our results. King et al examined 120 pregnant females and found significantly higher depression scores in those with HG than in a control group (35).…”

Investigating Maternal Serum Thyroid Hormone, Beta-Human Chorionic Gonadotropin (Beta-HCG) and Free Beta-HCG Levels in Hyperemesis Gravidarum

“…This clinical status has been reported in 0.3-0.5% of all live births (1,2). The etiology of HG is unknown; however, hormonal, metabolic, neurotic, and psychosomatic disorders are thought to be the etiological factors (9)(10)(11).…”

Preemptive Treatment of Nausea and Vomiting of Pregnancy: Results of a Randomized Controlled Trial

“…These may reflect more severe NVP symptoms due to less effective treatment. Depression by itself has not been shown to increase the likelihood of more common or more severe NVP [28] and headaches are not uncommon in severe forms of NVP. The significantly longer time till resolution of NVP in the control group and their higher likelihood of HG as compared to their previous pregnancy are consistent with our findings of lower quality of life among women with higher PUQE scores.…”