Delusion of Pregnancy

Abstract

Delusion of pregnancy is not a common phenomenon. Some cases have been reported [1], many of them on male patients. Delusions of pregnancy have been reported in fictional psychosis [2] and a wide variety of organic psychiatric conditions [1], including association with urinary tract infection [3]. It has been reported, more commonly in men than in women [4,5]. We report a patient of schizophrenia experiencing delusion of pregnancy that he attributed to sexual abuse occurring 10 years previously.A 3 6 -y e a r-old single man living in supported accommodation presented with acute psychosis characterised by being abusive towards strangers and coresidents, shadow boxing in the front garden, marked i r r i t a b i l i t y, poor sleep, and talk of a gay man following him around. He had complained of abdominal pain, which he believed was in the context of him being pregnant. He had nightmares and ruminations about his sexual abuse many years ago. He also had a background of mild to moderate intellectual disability.He had a past history of a similar episode in which he experienced aggression, was suicidal and had homicidal ideations. He believed that he had been pregnant for 2-3 months and his abdomen was swollen due to spontaneous fertilisation. His mother was diagnosed as having schizophrenia. Ten years ago he had experienced sexual abuse involving penetration. Since then, he had developed a delusional belief about pregnancy when unwell. There was no history of drug or alcohol abuse.Mental State Examination revealed him to be older than his age and guarded. He had ideas of reference, delusion of pregnancy, persecutory delusions, auditory hallucinations and poor insight. He was diagnosed as having schizophrenia and treated with antipsychotic medications. He showed a gradual response, and in 3 weeks his delusions started diminishing. His belief of pregnancy changed to an overvalued idea, and after 2 months he no longer believed in it.Delusion of pregnancy attributed to sexual abuse in men (as in the case above) has not been reported. It is interesting that in both episodes the patient exhibited this delusion, although the sexual abuse occurred 10 years previously. The delusion in this patient could not be attributed to other factors such as contact with pregnant women [5], underlying a medical cause [3].

Delusion of Test-Tube Pregnancy in a Sexually Abused Girl

“…Delusion of pregnancy attributed to sexual abuse in the past has been reported previously [14]. It is interesting to note that, with the advancement of reproductive technology, the content of delusions of pregnancy has also changed.…”

Pseudocyesis in peri- and postmenopausal women

“…Polydipsia associated with the syndrome of spurious pregnancy has been described in a schizoid 23-year-old patient [16]. Some authors consider that pseudocyesis is underlain by prolactin hypersensitivity with consequential immunoreactivity [1,4,6,7,[11][12][13][14], whereas others believe that some neuroleptics can induce galactorrhea and the consequential symptoms of spurious pregnancy [17]. Griengl describes pseudocyesis in a patient with primary sterility without organic cerebral pathology and previous psychiatric disorders [6].…”

“…graviditas immaginata) is a rare psychopathological syndrome described in humans and higher mammals. It is most commonly encountered in elderly, fertile, menopausal women, less frequently in postmenopausal women [1][2][3][4][5][6][7][8], and even more infrequently in adolescence and childhood [9]. According to DSM IV (The Diagnostic and Statistical Manual of Mental Disorders ) classification, pseudocyesis is categorized as a "somatoform disorder not otherwise specified" [10].…”

“…Psychopathologically, the syndrome is mostly underlain by schizophrenia, dissociative states of anxious disorders, progressive palsy, mood disorders, conversion neurosis, and psychosis with a strong auto suggestive compulsion for two reasons, fear from pregnancy or, more frequently, a strong wish for pregnancy. The syndrome rarely develops without such a psychopathological basis, occasionally in the period of climacterium [1,3,11,12]. Hippocrates described 12 cases of pseudocyesis.…”

Delusions of Pregnancy with Post-Partum Onset: An Integrated, Individualized View

“…Both of them were neglected by their emotionally unavailable, cold and careless mothers, who did not protect them from neglect and/ or abuse. Nevertheless, past sexual abuse was found to directly predispose patients to develop delusional pregnancy 36 .…”