Anxiety Disorders Following Miscarriage
J Clin Psychiatry 2001;62(6):432-438
© Copyright 2014 Physicians Postgraduate Press, Inc.
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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 examines the incidence of and relative risk for 3 DSM-III
anxiety disorders (obsessive-compulsive disorder [OCD], panic
disorder, and phobic disorders) within the 6 months following
miscarriage. Adequate diagnostic data on other 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 the 6 months following loss.
The miscarriage cohort consisted of women attending a medical
center for spontaneous abortion (N = 229); the comparison group
was a population-based cohort of women drawn from the community
(N = 230).
Results: Among miscarrying women, 3.5%
experienced a recurrent episode of OCD, compared with 0.4% of
community women (relative risk [RR] = 8.0; 95% confidence
interval [CI] = 1.0 to 63.7). The relative risk for noncomorbid
panic disorder was substantial (RR = 3.6), albeit not
statistically significant (95% CI = 0.8 to 17.2). There was no
strong evidence for increased risk for phobic disorders or
agoraphobia, combined or considered separately, in the 6 months
following loss. Relative risk for all 3 disorders combined was
1.5 (95% CI = 0.9 to 2.3).
Conclusion: In this first miscarriage cohort
study using a concurrent frequency-matched comparison group,
miscarriage was a substantial risk factor for an initial or
recurrent episode of OCD. Given statistical power limitations of
this investigation, the current findings do not preclude a
possible contribution of miscarriage to risk for other anxiety