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      History of depression and risk of hyperemesis gravidarum: a population-based cohort study

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          Abstract

          Hyperemesis gravidarum (HG) is a pregnancy condition characterised by debilitating nausea and vomiting. HG has been associated with depression during pregnancy but the direction of the association remains unclear. The aim of this study was to assess whether previous depression is associated with HG. This is a population-based pregnancy cohort study using data from The Norwegian Mother and Child Cohort Study. The study reviewed 731 pregnancies with HG and 81,055 pregnancies without. Logistic regression analyses were performed to examine the association between a lifetime history of depression and hyperemesis gravidarum. Odds ratios were adjusted for symptoms of current depression, maternal age, parity, body mass index, smoking, sex of the child, education and pelvic girdle pain. A lifetime history of depression was associated with higher odds for hyperemesis gravidarum (aOR = 1.49, 95% CI (1.23; 1.79)). Two thirds of women with hyperemesis gravidarum had neither a history of depression nor symptoms of current depression, and 1.2% of women with a history of depression developed HG. A lifetime history of depression increased the risk of HG. However, given the fact that only 1.2% of women with a history of depression developed HG and that the majority of women with HG had no symptoms of depression, depression does not seem to be a main driver in the aetiology of HG.

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          Most cited references34

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          The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures.

          The Composite International Diagnostic Interview (CIDI), written at the request of the World Health Organization/US Alcohol, Drug Abuse, and Mental Health Administration Task Force on Psychiatric Assessment Instruments, combines questions from the Diagnostic Interview Schedule with questions designed to elicit Present State Examination items. It is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer. A special Substance Abuse Module covers tobacco, alcohol, and other drug abuse in considerable detail, allowing the assessment of the quality and severity of dependence and its course. This article describes the design and development of the CIDI and the current field testing of a slightly reduced "core" version. The field test is being conducted in 19 centers around the world to assess the interviews' reliability and its acceptability to clinicians and the general populace in different cultures and to provide data on which to base revisions that may be found necessary. In addition, questions to assess International Classification of Diseases, ninth revision, and the revised DSM-III diagnoses are being written. If all goes well, the CIDI will allow investigators reliably to assess mental disorders according to the most widely accepted nomenclatures in many different populations and cultures.
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            How well can a few questionnaire items indicate anxiety and depression?

            There is a need for a short form questionnaire with known psychometric characteristics that may be used as an indicator of level of global mental distress. A weighted sum of 5 questions from the Symptom Check List (SCL) anxiety and depression subscales (SCL-25) correlates at r = 0.92 with the global SCL-25 score. The alpha reliability for the (5-item) short form questionnaire was 0.85%. Age differences seemed to be trivial, and sex differences were moderate. Descriptive statistics for short form scores in a large, representative sample are given.
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              Concordance between symptom screening and diagnostic procedure: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview I.

              The definition of case is a core issue in psychiatric epidemiology. Psychiatric symptom screening scales have been extensively used in population studies for many decades. Structured diagnostic interviews have become available during recent years to give exact diagnoses through carefully undertaken procedures. The aim of this article was to assess how well the Hopkins Symptom Checklist-25 (HSCL-25) predicted cases by the Composite International Diagnostic Interview (CIDI), and find the optimal cut-offs on the HSCL-25 for each diagnosis and gender. Characteristics of concordant and discordant cases were explored. In a Norwegian two-stage survey mental health problems were measured by the HSCL-25 and the CIDI. Only 46% of the present CIDI diagnoses were predicted by the HSCL-25. Comorbidity between CIDI diagnoses was found more than four times as often in the concordant cases (case agreed upon by both instruments) than in the discordant CIDI cases. Concordant cases had more depression and panic/generalized anxiety disorders. Neither the anxiety nor the depression subscales improved the prediction of anxiety or depression. The receiver operating characteristic (ROC) curves confirmed that the HSCL-25 gave best information about depression. Except for phobia it predicted best for men. Optimal HSCL-25 cut-off was 1.67 for men and 1.75 for women. Of the discordant HSCL-25 cases, one-third reported no symptoms in the CIDI, one-third reported symptoms in the CIDI anxiety module, and the rest had symptoms spread across the modules. With the exception of depression, the HSCL-25 was insufficient to select individuals for further investigation of diagnosis. The two instruments to a large extent identified different cases. Either the HSCL-25 is a very imperfect indicator of the chosen CIDI diagnoses, or the dimensions of mental illness measured by each of the instruments are different and clearly only partly overlapping.
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                Author and article information

                Contributors
                + 47 48 34 01 65 , Helena.Kames.Kjeldgaard@ahus.no
                Journal
                Arch Womens Ment Health
                Arch Womens Ment Health
                Archives of Women's Mental Health
                Springer Vienna (Vienna )
                1434-1816
                1435-1102
                7 January 2017
                7 January 2017
                2017
                : 20
                : 3
                : 397-404
                Affiliations
                [1 ]ISNI 0000 0000 9637 455X, GRID grid.411279.8, , Health Services Research Unit, Akershus University Hospital, ; Post Box 1000, 1478 Lørenskog, Norway
                [2 ]ISNI 0000 0004 1936 8921, GRID grid.5510.1, Institute of Clinical Medicine, Campus Ahus, , University of Oslo, ; Lørenskog, Norway
                [3 ]ISNI 0000 0001 1541 4204, GRID grid.418193.6, Domain for Mental and Physical Health, , Norwegian Institute of Public Health, ; Oslo, Norway
                [4 ]ISNI 0000 0004 1936 8921, GRID grid.5510.1, PharmacoEpidemiology & Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, , University of Oslo, ; Oslo, Norway
                [5 ]ISNI 0000 0004 0389 8485, GRID grid.55325.34, , The Intervention Centre, Oslo University Hospital, ; Oslo, Norway
                Article
                713
                10.1007/s00737-016-0713-6
                5423929
                28064341
                a9638ea8-8429-4225-a500-6af35fed7495
                © The Author(s) 2017

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 21 December 2016
                : 26 December 2016
                Funding
                Funded by: South-Eastern Norway Regional Health Authority
                Award ID: 2014003
                Award Recipient :
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag Wien 2017

                Clinical Psychology & Psychiatry
                depression,hyperemesis gravidarum,mental health,nausea and vomiting,norwegian mother and child cohort study

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