Anxiety disorders following miscarriage

Background: Several previous studies have established that miscarriage is a risk factor for depressive symptoms and disorder. By contrast, research on miscarriage as a possible risk factor for anxiety symptoms is inconclusive , and for anxiety disorders, sparse and uninformative. The current study ex amines the incidence of and relative risk fur 3 DSM-III anxiety disorders ( obsessive-compulsive disorder [OCD], panic disorder, and phobic disorders) within the 6 months following miscarriage. Adequate diagnostic data on othe r anxiety disorders were not available. Method: Using a cohort design, we tested whether women who miscarry are at increased risk for a first or recurrent episode of an anxiety disorder in t he 6 months following loss. The miscarriage cohort consisted of women atten ding a medical center for spontaneous abortion (N = 229); the comparison gr oup was a population-based cohort of women drawn from the community (N = 23 0). Results: Among miscarrying women, 3.5% experienced a recurrent episode of O CD, compared with 0.4% of community women (relative risk [RR] = 8.0; 95% co nfidence interval [CI] = 1.0 to 63.7). The relative risk for nonco-morbid p anic disorder was substantial (RR = 3.6), albeit not statistically signific ant (95% CI = 0.8 to 17.2). There was no strong evidence for increased risk fur phobic disorders or agoraphobia, combined or considered separately, in the 6 months following loss. Relative risk for all 3 disorders combined wa s 1.5 (95% CI = 0.9 to 2.3). Conclusion: In this first miscarriage cohort study using a concurrent frequ ency-matched comparison group, miscarriage was a substantial risk factor fo r an initial or recurrent episode of OCD. Given statistical power limitatio ns of this investigation, the current findings do not preclude a possible c ontribution of miscarriage to risk for other anxiety disorders.