Pseudocyesis (False Pregnancy)

Primer

Pseudocyesis (from the Greek: pseudes [false] and kyesis [pregnancy]), also known as false, imaginary, simulated, phantom, hysterical or spurious pregnancy is a rare mental/psychosomatic disorder characterized by a false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy. This may include abdominal enlargement, reduced menstrual flow, amenorrhea, subjective sensation of fetal movement, nausea, breast engorgement and secretions, and labor pains at the expected date of delivery.

Epidemiology

Pseudocyesis is extremely rare. Roughly 550 to 600 cases have been reported in the English medical literature, beginning from the eighteenth century.[1] It is most commonly found in rural and undeveloped countries where women are not routinely examined by physicians.[2] It is most common in women aged 20 to 39 years, but has also been described in premenarchal (6 years old) and postmenopausal women (79 years old).[3] The incidence has fallen dramatically, in the last fifty years, likely due to a number of sociocultural and medical factors.

History

Culture

Sociocultural and psychological factors often contribute to pregnancy and childbearing being of central importance to the identity and selfesteem of such women.

Diagnostic Criteria

The DSM-5 does not have diagnostic criteria for pseydocyesis, but includes it under the diagnostic group of Other Specified Somatic Symptom and Related Disorder. This category applies to presentations in which symptoms characteristic of a somatic symptom and related disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the somatic symptom and related disorders diagnostic class.

Pathophysiology

Endocrine

Psychological

A psychological formulation and understanding of pseudocyesis includes:

  1. A pathological wish for or fear of being pregnant[4]
  2. Ambivalence or conflict regarding gender, sexuality, or child bearing[5]
  3. Grief reaction following miscarriage, tubal ligation or hysterectomy[6]

References

1) Whelan, C. I., & Stewart, D. E. (1990). Pseudocyesis—a review and report of six cases. The International Journal of Psychiatry in Medicine, 20(1), 97-108.
2) Tarín, J. J., Hermenegildo, C., García-Pérez, M. A., & Cano, A. (2013). Endocrinology and physiology of pseudocyesis. Reproductive Biology and Endocrinology, 11(1), 39.
3) Cohen, L. M. (1982). A current perspective of pseudocyesis. The American journal of psychiatry, 139(9), 1140-1144.
4) Whelan, C. I., & Stewart, D. E. (1990). Pseudocyesis—a review and report of six cases. The International Journal of Psychiatry in Medicine, 20(1), 97-108.
5) Fried, P. H., Rakoff, A. E., Schopbach, R. R., & Kaplan, A. J. (1951). Pseudocyesis: A psychosomatic study in gynecology. Journal of the American Medical Association, 145(17), 1329-1335.
6) Whelan, C. I., & Stewart, D. E. (1990). Pseudocyesis—a review and report of six cases. The International Journal of Psychiatry in Medicine, 20(1), 97-108.