The psychological impact of prenatal DES exposure in women: a comparison of short-term and long-term effects

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Abstract
The psychological impact of knowledge of DES exposure on young women was evaluated and compared for 3 time points: (1) following the disclosure of their DES exposure, (2) following their first DES-related examination (both retrospectively), and (3) at the time of the interview. Sixty DES-exposed daughters described their reactions and worries at each time point in the context of a semi-structured open-ended interview. Results showed: (1) The majority of women initially reacted with mild to moderate levels of distress and were worried about, in descending order: the cancer risk, potential pregnancy problems, and the effect on their sex life. (2) The DES exam served to reduce worry in all major areas of concern and represents the time at which the women felt least distressed about issues related to the DES exposure. (3) Surprisingly, there has been an increase in distress from the time following the first exam to the present. Present levels of distress and worries among women in our sample nearly equalled those reported at the time of disclosure, a period on average of 6.5 years ago. The focus of worries, however, has changed from the cancer risk to worries about pregnancy difficulties, with the additional categories of fear of effects on their children and on themselves as they grow older (e.g., during menopause). These self-reports indicate that there are long-term worries and distress related to DES exposure. It is also noted that the women's self-report of level of distress is consistent with difficulties noted by interviewers concerning the women's general current psychological functioning as measured by the Global Assessment Scale (GAS) and concerning their history of depression as evaluated by the Schedule for Affective Disorders and Schizophrenia, Lifetime Version (SADS-L).