Delusion of Pregnancy: A Systematic Review of 84 Cases in the Literature

Abstract

Case reports of delusion of pregnancy have emanated from all over the world, yet the rarity of this phenomenology has precluded systematic large scale descriptive or cohort studies. This systematic review was conducted to assess the demographic characteristics, clinical profile, treatment outcome and aetiological factors from the published case reports of delusion of pregnancy. Electronic databases including PubMed, PsychInfo and Google Scholar were used to identify case reports relating to delusion of pregnancy published in peer-reviewed English language journals. All such cases were systematically evaluated by investigators, and information was extracted using a structured proforma. A total 40 articles were reviewed which included 84 cases. Demographic characteristics revealed that about half of the patients were aged 20-40 years. The most common diagnoses were schizophrenia (35.7%), bipolar disorders (16.7%) and depression (9.5%). Single foetus was reported by 79.8% of the patients, and 45.2% perceived foetal movements. Good treatment response was noted in 64.3 % of the cases. The prominent aetiological factors that were implicated included psychosocial factors, coenaesthopathological processes, socio-cultural factors and hyperprolactinaemia. Delusion of pregnancy is a heterogeneous symptom which emerges during the course of various neuropsychiatric disorders. A range of aetiopathological mechanisms have been implicated in the causation of this disorder.

A 39‐year‐old man with schizophrenia and tuberous sclerosis with a delusion of being a pregnant woman—A case report

“…Delusion of pregnancy is an unusual presentation that can be part of delusional disorder, schizophrenia or other psychotic disorders . It can also be associated with organic disorders such as epilepsy, hyponatremia, hypothyroidism, metabolic syndrome, and others.…”

“…Although most patients presenting with this kind of delusion are females, it has also been reported in males. In some cases, male patients attributed their ability to become pregnant to homosexual relations; in one of these cases, the patient believed he is experiencing pregnancy changes and is turning into a woman …”

“…Most cases were associated with one fetus and few involved multiple fetuses. Other features associated with the delusion included auditory hallucinations of hearing the fetus which was reported in very few cases mainly associated with schizophrenia and fetal movements …”

“…1,2 It can also be associated with organic disorders such as epilepsy, hyponatremia, hypothyroidism, metabolic syndrome, and others. In some cases, it was attributed to hyperprolactinemia induced by antipsychotics or other organic causes [1][2][3] ; false impression or interpretation of body sensations (coenesthesia); and psychosocial factors including wish fulfillment, due to lack or loss of children or spouse for instance, and cultural pressures on women to have children. 1,2,4 Although most patients presenting with this kind of delusion are females, it has also been reported in males.…”

“…In some cases, it was attributed to hyperprolactinemia induced by antipsychotics or other organic causes [1][2][3] ; false impression or interpretation of body sensations (coenesthesia); and psychosocial factors including wish fulfillment, due to lack or loss of children or spouse for instance, and cultural pressures on women to have children. 1,2,4 Although most patients presenting with this kind of delusion are females, it has also been reported in males. In some cases, male patients attributed their ability to become pregnant to homosexual relations; in one of these cases, the patient believed he is experiencing pregnancy changes and is turning into a woman.…”