Past Issues

Hyperemesis Gravidarum: A Psychosomatic Disease?

Shen-Chieh Chang, M.D., Eng-Kung Yeh, M.D.

Background: Having been long seen as a psychosomatic disease, hyperemesis gravidarum (HG) has, received little attention in Taiwan psychiatry. The Case: We are presenting a case of 35-year-old married woman with HG in her 11th week of gestation. Her obstetrician requested us to see this patient in a psychiatric consultation. The case was discussed in the weekly teaching consultation case conference twice consecutively in 2006. Discussion: We discussed the issues of psychogenic theory of HG, dissenting views against the HG psychogenesis, accepting the patient as she is, weighing the risk and benefit of the antidepressant therapy, and the limitation of this case presentation. Conclusion: HG is rarely seen in consultation psychiatry, but should be reminded as a psychosomatic disease. Based on the findings of this case and the literature, we conclude that HG patients could be better benefited from an earlier psychosocial intervention for the well-being of both mother and fetus.
Key Word nausea, vomiting, antidepressant, hormone
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