The Evaluation of Attachment Style and Temperament in Patients With Hyperemesis Gravidarum: Does the Idea That Hyperemesis Gravidarum Has a Psychological Origin Persist?

Background: Hypremesis Gravidarum (HG) is a common disease in pregnancy during the first trimester. Patients suffering from HG commonly present with dehydration, nutritional depletion, electrolyte imbalance, and the loss of at least 5% of body weight. Although the psychological etiology of HG is not clear, it has been shown that psychiatric symptoms are extensively present in patients with HG. Objectives: The aim of this study was to investigate the relationship between temperament, attachment style and hyperemesis gravidarum. Materials and Methods: This case-control study was conducted at Kirikkale University Hospital in Kirikkale, Turkey, between May 2015 and May 2017. A total of 98 pregnant women suffering from HG in their first trimester of pregnancy (HG group) and 95 healthy pregnant women in their first trimester of pregnancy (control group) were included in the study. Adult attachment styles were determined as secure, fearful, preoccupied, and dismissing. The evaluation of temperament was done using the TEMPS-A scale. Results: The mean secure attachment style score in the HG group was 3.9 ± 0.9 and significantly lower than the mean attachment style score (4.6 ± 1.1) in the control group (P = 0.001). In the TEMPS-A scale, patients with HG showed significantly higher mean depressive (9.7 ± 3.8) and mean anxious scores (13 ± 2.3) than those of the control group (6.6 ± 2.9 and 8 ± 0.9, respectively) (P = 0.001 and P = 0.040, respectively). Conclusions: This study revealed that HG patients had more common depressive and anxious temperament characteristics and lower secure attachment style than non-HG patients. Due to the fact that attachment and temperament styles are relatively stable throughout life, we thought that psychiatric problems may play a role on development of HG.