Priority 19 from the Hyperemesis Gravidarum PSP

UNCERTAINTY: What is the effect of hyperemesis gravidarum on mental health during pregnancy? What is the efficacy of psychotherapy on symptom management/pregnancy outcomes/quality of life? How can women access psycho-supportive services during pregnancy? (JLA PSP Priority 19)
Overall ranking	19
JLA question ID	0090/19
Explanatory note	Not available for this PSP
Evidence	Systematic review and meta-analysis have shown a significantly increased frequency of depression and anxiety in women with HG. Ref: Mitchell-Jones N, Gallos I, Farren J, Tobias A, Bottomley C, Bourne T. Psychological morbidity associated with hyperemesis gravidarum: a systematic review and meta-analysis. Bjog. 2017;124(1):20-30. For interventions, various studies have assessed interventions, SR may be possible but question is not currently answered.
Health Research Classification System category	Reproductive health and childbirth

Extra information provided by this PSP
Original uncertainty examples	How does the mental component of HG (desperation, exhaustion, feeling that 'I can't do this for another eight months') influence the patients physical wellbeing and how do we include mental health care in the treatment? ~ Can mental health support be provided at home for those who are unable to travel alone? ~ How do we support women with HG before, during and after pregancy psychologicly? ~ What mental health support is available for women and how can we improve access to this service for women who struggle to leave the house when suffering with HG? ~ What support is available for the psychological repercussions of HG? ~ Comparison between conventional medical treatment and psychotherapy for hyperemesis gravidarum. What are the barriers to women accessing counselling for HG ~ Suicidal thoughts and HG. How can this be better supported by the the community midwife and mental health team?
Submitted by	Patients x 172 ~ Healthcare professionals x 20 ~ Carers x 7 ~ Offspring x 25 ~ Organisational representatives x 2 ~ Unknown x 6

Extra information provided by this PSP

Original uncertainty examples

How does the mental component of HG (desperation, exhaustion, feeling that 'I can't do this for another eight months') influence the patients physical wellbeing and how do we include mental health care in the treatment? ~ Can mental health support be provided at home for those who are unable to travel alone? ~ How do we support women with HG before, during and after pregancy psychologicly? ~ What mental health support is available for women and how can we improve access to this service for women who struggle to leave the house when suffering with HG? ~ What support is available for the psychological repercussions of HG? ~ Comparison between conventional medical treatment and psychotherapy for hyperemesis gravidarum. What are the barriers to women accessing counselling for HG ~ Suicidal thoughts and HG. How can this be better supported by the the community midwife and mental health team?

Submitted by

Patients x 172 ~ Healthcare professionals x 20 ~ Carers x 7 ~ Offspring x 25 ~ Organisational representatives x 2 ~ Unknown x 6

PSP information
PSP unique ID	0090
PSP name	Hyperemesis Gravidarum
Total number of uncertainties identified by this PSP.	65 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	9 October 2019