Hyperemesis gravidarum as conversion disorder

Psychosocial factors have long been believed to be important in the pathogenesis of emesis gravidarum (morning sickness) and hyperemesis gravidarum (HG). Although this has been confirmed during extensive studies over the last 30 years, HG has never been described as a conversion reaction. We describe two women presenting with hyperemesis who clearly fulfill diagnostic criteria for conversion. We suggest that strong psychodynamic conflicts are expressed by this potentially dangerous symptom in a subset of individuals and that dynamic interventions have a role in treating certain patients with HG.