The literature on the psychological, social and biological factors in the etiology of hyperemesis gravidarum is reviewed. Four cases seen in the last year in psychiatric consultation in a general hospital are then presented to illustrate and highlight the biopsychosocial factors in the literature that seemed most relevant to diagnosis and treatment. Emphasis is placed on the concept of hyperemesis gravidarum as a special type of somatization (an illness behavior in which dysphoric affect is expressed with physical symptoms), whereby physical symptoms are expressed to elicit care by physicians and family and to gain a “time out” from stressful home environments.
Get full access to this article
View all access options for this article.
References
1.
TaylorH. P., Nausea and Vomiting or Pregnancy, KrogerW. (ed.), Psychosomatic Obstetrics. Gynecology and Endocrinology, Charles C. Thomas Publishers, Springfield, Illinois, pp. 115–126, 1962.
2.
ChertockL., Hyperemesis Gravidarum, HowellsJ. G. (ed.), Modern Perspective in Psycho-Obstetrics, Brunner Mogel Publisher, New York, p. 238, 1972.
3.
DoerrH., Hyperemesis Gravidarum, GuzinskiG.GrossR. (eds.), Psychophysiological Problems in Obstetrics and Gynecology, in press.
4.
FairweatherD. V. I., Hyperemesis Gravidarum, M.D. Thesis, University of St. Andrews, 1965.
5.
FairweatherD. V. I., Nausea and Vomiting in Pregnancy, Am. J. Obs. and Gyn., 102, pp. 135–175, 1968.
6.
EngelG. L., The Need for a New Medical Model: A Challenge for Biomedicine, Science, 196, pp. 129–136, 1977.
7.
SemmensJ. P., Hyperemesis Gravidarum Evaluation and Treatment, Obs. and Gyn., 9, p. 586, 1957.
8.
FitzgeraldJ. P. B., Epidemiology of Hyperemesis Gravidarum, Lancet, 1, pp. 660–662, 1956.
9.
RobertsonG. G., Nausea and Vomiting of Pregnancy, Lancet, 2, p. 336, 1946.
10.
KaltenbachR., Ueber Hyperemesis Gravidarum, Ztschr. Gebutsch. U. Gynak., 21, p. 200, 1891.
11.
MenningerK. A., Somatic Correlations with Unconscious Repudiation of Femininity in Women, J. Nerv. & Mental Dis., 89, pp. 514–527, 1939.
12.
WeissE.EnglishO. S., Psychosomatic Medicine, W. B. Saunders Company, Philadelphia, 1943.
13.
BruchH., Eating Disorders, Basic Books, Inc., New York, 1973.
14.
GraceW. J.GrahamD. T., Relationship of Specific Attitudes and Emotions to Certain Bodily Diseases, Psychosom. Med., 14, pp. 243–251, 1952.
15.
GrahamD. T.SteinJ. A.WinokurG., Experimental Investigation of the Specifics of Attitude Hypothesis in Psychosomatic Disease, Psychosom. Med., 20, pp. 446–457, 1958.
16.
KrogerW. S.DeLeeS. T., The Psychosomatic Treatment of Hyperemesis Gravidarum by Hypnosis, Am. J. Obs. & Gyn., 51, pp. 544–552, 1946.
17.
HenkerF. O., Psychotherapy as Adjunct in Treatment of Vomiting During Pregnancy, South. Med. J., 69, pp. 1585–1587, 1976.
18.
HarveyW. A.SherfeyM. J., Vomiting in Pregnancy, Psychosom. Med., 16, p. 1, 1954.
19.
PurtelJ. J.RobinsE.CohenM. E., Observations on Clinical Aspects of Hysteria: Quantitative Study of 50 Hysteria Patients and 156 Control Subjects, JAMA, 146, pp. 902–909, 1951.
20.
GuzeS. B.DelongW. B.MajerusP. W., Association of Clinical Psychiatric Disease with Hyperemesis Gravidarum, New Eng. J. Med., 261, pp. 1363–1368, 1959.
21.
GuzeS. B.AllenD. H.GrollmusJ. J., The Prevalence of Hyperemesis Gravidarum: A Study of 162 Psychiatric and 98 Medical Patients, Am. J. Obs. & Gyn., 84, pp. 1859–1864, 1962.
22.
TyldenE., Hyperemesis and Physiological Vomiting, J. Psychosom. Res., 12, p. 85, 1968.
23.
WolkindS.ZajicekE., Psycho-social Correlates of Nausea and Vomiting of Pregnancy, J. Psychosom. Res., 22, pp. 1–5, 1978.
24.
GundersonJ.SingerM. T., Defining Borderline Patients: An Overview, Am. J. Psychiatry, 132, p. 1, 1975.
25.
FeighnerJ. P.RobinsE.GuzeS. B., Diagnostic Criteria for Use in Psychiatric Research, Arch. Gen. Psychiatry, 26, pp. 57–63.
26.
LazareA.KlermanG., Hysteria and Depression: The Frequency and Significance of Hysterical Personality Features in Hospitalized Depressed Women, Am. J. Psychiatry, 124, pp. 48–56, 1968.
