Early pregnancy sickness and vomiting/Hyperemesis gravidarum - Actual knowledge regarding pychosomatic aspects

Background: Although Hyperemesis gravidarum (HG) is still a disease of unkn own aetiology psychosocial aspects are involved in the genesis of this dise ase. Materials and methods: Based on experiences in our department and on actual literature psychosocial aspects and therapeutic approaches of HC are prese nted. Results: Predisposing factors of HC are stress, inadequate information abou t pregnancy or delivery and problems in the marital relationship. Feelings of ambivalence towards pregnancy, a distorted perception of reality, the un conscious refusing of a wanted child and the worry about a relation between nutrition of the foetus and the HG have influence on the development of th e HC. The role of the social context, especially the mother, of expectation s towards vomiting and of secondary gain in the genesis and the evaluation of HG is explained. Therapeutical approaches beside the known somatic therapies are acupuncture , the electric stimulation of the N. vestibularis and different methods of psychotherapy, which can include the partner or other persons from the soci al context. In some cases an intensified therapy under in-patient: conditio ns can improve therapeutic results. Discussion: Psychosocial factors are involved not only in the genesis of HG , but also in the duration and intensity of symptoms as well as in the resi stance especially towards isolated somatic therapeutical approaches. Conclusions: When psychosocial factors are taken into account in the search for a cause and the treatment of HG results of treatment are more successf ul and persist over a longer time.