Pseudocyesis

Pseudocyesis: Psychologic and neuroendocrine interrelationships.
Starkman, Monica N., et al.
Psychosomatic Medicine, Vol 47(1), Jan-Feb, 1985. pp. 46-57.
Abstract:
Studied a 30-yr-old woman and a 38-yr-old woman with pseudocyesis (the false belief in pregnancy), using a multimodal investigatory approach focusing on the association of depression and alterations in endocrine secretory patterns. Results show that both Ss had abnormal growth hormone secretory patterns, as demonstrated by lack of sleep-associated peaks and the absence of a response to levodopa administration. Both Ss had elevated testosterone and estradiol levels and normal prolactin levels. One S met DSM-III criteria for a major depressive episode, and she had abnormally elevated luteinizing hormone (LH) levels and large LH pulse amplitudes. These findings, together with a review of cases reported in the literature, suggest that no single neuroendocrine profile is common to all patients with pseudocyesis.

Pseudocyesis: An overview.
Small, Gary W.
The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, Vol 31(5), Jun, 1986.
Abstract:
Reviews the medical literature on pseudocyesis, the condition in which a nonpregnant woman believes she is pregnant and has objective signs of pregnancy. The disorder involves both psychological and neuroendocrine mechanisms and is related to other conditions varying in severity from fleeting fears and wishes in healthy women to pathological changes in neuroendocrine functions in others. The notion that the condition is heterogeneous and closely related to other more common disorders is emphasized. Implications for assessment and treatment are discussed.

Recurrent pseudocyesis and hypomania.
Taylor, J. and Kreeger, A.
The British Journal of Psychiatry, Vol 151, Jul, 1987. pp. 120-122.
Abstract:
Presents the case report of a 21-yr-old woman with 3 distinct episodes of pseudocyesis occurring concurrently with annual hypomanic illness. The association between pseudocyesis and affective disorder is discussed, with regard to possible underlying psychopathology and previously proposed psychoneuroendocrine mechanisms.

Pseudocyesis preceding psychosis.
Mortimer, Ann and Banbery, Jo.
The British Journal of Psychiatry, Vol 152, Apr, 1988. pp. 562-565.
Abstract:
Reports a case of pseudocyesis in a 21-yr-old female with symptoms of acute schizophrenia. Overvalued ideation (i.e., pregnancy) disappeared after neuroleptic treatment.

Pseudocyesis: A model for cultural, psychological, and biological interplay.
Miller, William H. and Maricle, Robert
Journal of Psychosomatic Obstetrics & Gynecology, Vol 8(3), Jun, 1988. pp. 183-190.
Abstract:
Discusses recent information, including biological, psychological, and cultural factors, in the supposedly rare disorder of pseudocyesis (pseudopregnancy or delusional or factitious pregnancy). Among psychological explanations, psychodynamic ones have dominated, theorizing that a patient may experience pseudocyesis to maintain a relationship, as a defense against depersonalization, for omnipotence, or for self-punishment. Sociocultural studies show that pseudocyesis occurs more often in cultures or economic subgroups that place great value on fertility. Biological studies are incomplete but indicate a neuroendocrine vulnerability. It is suggested that pseudocyesis may provide a model for the investigation of mind–body interplay across a range of gynecologic and obstetric disorders.

Pseudocyesis: A review and report of six cases.
Whelan, Chantal I. and Stewart, Donna E.
International Journal of Psychiatry in Medicine, Vol 20(1), 1990. pp. 97-108.
Abstract:
Pseudocyesis is a rare condition in which a woman believes herself to be pregnant when she is not. Its incidence has fallen in the last 50 yrs, probably due to a number of sociocultural and medical factors. Six cases of women (aged 20–35 yrs) are described, which show common features of recent pregnancy loss or infertility, psychological and medical naivete, social isolation, recent loss, and membership in a cultural or religious group that focuses on childbearing as the central role of women. Etiology includes psychological, sociocultural, and endocrine factors, which interact with each other demonstrating the reciprocal interplay between mind and body. Guidelines are provided for the assessment and management of this ancient and fascinating condition.

Pseudocyesis.
Paulman, Paul M. and Sadat, Abdul
The Journal of Family Practice, Vol 30(5), May, 1990. pp. 575-576.
Abstract:
Discusses epidemiology, signs and symptoms, laboratory findings, diagnosis, and treatment of pseudocyesis (spurious pregnancy). In the literature, conflict theory, wish-fulfillment theory, and depression theory have been most widely accepted etiologies. An illustrative case involving a 30-yr-old single woman with an abdominal hysterectomy is included.

Pseudocyesis in organic mood disorders: Six cases.
Signer, Stephen F., et al.
Psychosomatics: Journal of Consultation and Liaison Psychiatry, Vol 33(3), Sum 1992. pp. 316
Abstract:
Presents cases of 6 women (aged 27–68 yrs) who experienced a delusion of pregnancy caused by brain injury in the context of a mood disorder. Other disorders in which this false belief can occur are reviewed. The delusion is reviewed with respect to the entities it overlaps, and the clinical manifestations are related to the mood disorders. Although no clear neuroanatomic localization was possible with these Ss, there may be some association with desomatization caused by parietal lobe dysfunction.

Has pseudocyesis become an outmoded diagnosis?
Gaskin, Ina May.
Abstract:
This article focuses on pseudocyesis or false pregnancy. Time was when every obstetrics text included a description and discussion of pseudocyesis,otherwise known as false, imaginary, phantom, hysterical, or spurious pregnancy. Many 19th century authors pointed out that the woman having a false pregnancy generally would be newly married or near menopause and, in most cases, eager to be pregnant. According to textbooks, the usual scenario in a false pregnancy would be that a woman would come to the doctor with a distended abdomen, swollen breasts, darkened areolae, reporting that her menstrual period had stopped. Often, she would report morning sickness and fetal kicking. For the woman with pseudocyesis, however, the situation is different and often extremely humiliating, because most people, never having heard of the phenomenon, regard the woman who thought herself pregnant as delusional. Those who judge women in this condition have not experienced for themselves how convincing the symptoms can sometimes be. Some 19th century doctors who suspected that they might be dealing with a case of pseudocyesis were advised to anesthetize the woman to make a definitive diagnosis. This recommendation was made in those cases when the woman’s abdominal and pelvic muscles were too rigidly held for a manual examination to identify the uterus.