Pseudocyesis



Pseudocyesis 924
Photo by: Gladskikh Tatiana

Definition

Pseudocyesis is the medical term for a false pregnancy. Pseudocyesis can cause many of the signs and symptoms of pregnancy, and often resembles the condition in every way except for the presence of a fetus.

Description

Pseudocyesis has been observed and written about since antiquity. Hippocrates set down the first written account around 300 B.C., and recorded 12 different cases of women with the disorder. One of the most famous historical examples is Mary Tudor (1516-1558), Queen of England, who believed on more than one occasion that she was pregnant when she was not. Some even attribute the violence that gave her the nickname "Bloody Mary" as a reaction to the disappointment of finding out that she was not carrying a child. Other historians believe that the queen's physicians mistook fibroid tumors in her uterus for a pregnancy, as fibroids can enlarge a nonpregnant uterus.

Pseudocyesis has become increasingly rare in many parts of the world in which accurate pregnancy tests have become widely available. Cultures that place high value on pregnancy, or that make close associations between fertility and a person's worth, still have high rates of the disorder.

Signs and symptoms

The symptoms of pseudocyesis are similar to the symptoms of true pregnancy and are often hard to distinguish from such natural signs of pregnancy as morning sickness, tender breasts, and weight gain. Many health care professionals can be deceived by the symptoms associated with pseudocyesis. Eighteen percent of women with pseudocyesis were at one time diagnosed as pregnant by a medical professional. In some cases, the only difference between pregnancy and pseudocyesis is the presence of a fetus.

The sign of pseudocyesis that is common to all cases is that the affected patient is convinced that she is pregnant. Abdominal distension is the most common physical symptom of pseudocyesis (63– 97% of women are found to experience this). The abdomen expands in the same manner as it does during pregnancy, so that the affected woman looks pregnant. This phenomenon is thought to be caused by buildup of gas, fat, feces, or urine. These symptoms often resolve under general anesthesia and the woman's abdomen returns to its normal size.

The second most common physical sign of pseudocyesis is menstrual irregularity (56–98% of women experience this). Between 48% and 75% of women are also reported to experience the sensation of fetal movements known as quickening, even though there is no fetus present. Some of the other common signs and symptoms include: gastrointestinal symptoms, breast changes or secretions, labor pains, uterine enlargement, and softening of the cervix. One percent of women eventually experience false labor.

Causes

No single theory about the causes of pseudocyesis is universally accepted by mental health professionals. The first theory attributes the false pregnancy to emotional conflict. It is thought that an intense desire to become pregnant, or an intense fear of becoming pregnant, can create internal conflicts and changes in the endocrine system, which may explain some of the symptoms of pseudocyesis. The second theory concerns wish-fulfillment. It holds that if a women desires pregnancy badly enough she may interpret minor changes in her body as signs of pregnancy. The third leading theory is the depression theory, which maintains that chemical changes in the nervous system associated with some depressive disorders could trigger the symptoms of pseudocyesis.

Demographics

The rate of pseudocyesis in the United States has declined significantly in the past century. In the 1940s there was one occurrence for approximately every 250 pregnancies. This rate has since dropped to between one and six occurrences for every 22,000 births. The average age of the affected woman is 33, though cases have been reported for women as young as 6-1/2 and as old as 79. More than two-thirds of women who experience pseudocyesis are married, and about one-third have been pregnant at least once. Women who have been victims of incest may be at greater risk for developing pseudocyesis. Pseudocyesis is found in some mammals other than humans—most often cats, dogs, and rabbits.

Treatment

Because pseudocyesis is not known to have a direct underlying physical cause, there are no general recommendations regarding treatment with medications. In some cases, however, the patient may be given medications for such symptoms as the cessation of menstruation. Because most patients with pseudocyesis have underlying psychological problems, they should be referred to a psychotherapist for the treatment of these problems. It is important at the same time, however, for the treating professional not to minimize the reality of the patient's physical symptoms.

The treatment that has had the most success is demonstrating to the patient that she is not really pregnant by the use of ultrasound or other imaging techniques.

Alternative therapies

There have been reports of patients being cured of pseudocyesis by hypnosis, purgatives, massage, opioids, or after nine months of symptoms, by experiencing "hysterical childbirth," but there are few data available on the effectiveness of these or similar procedures.

Prognosis

Symptoms of pseudocyesis generally last from a few months to a few years. In most cases, symptoms last for a full nine months. There is a high success rate for treatments involving psychotherapy , as it treats the underlying psychological causes of the disorder.

Resources

BOOKS

Knobil, Ernst, and Jimmy D. Neill, eds. Encyclopedia of Reproduction . New York: Academic Press, 1998.

Sadock, Benjamin J. and Virginia A. Sadock, eds. Comprehensive Textbook of Psychiatry. 7th ed. Vol. 2. Philadelphia: Lippincott Williams and Wilkins, 2000.

PERIODICALS

Hendricks-Matthews, Marybeth K., Douglas M. Hoy. "Pseudocyesis in an Adolescent Incest Survivor." Journal of Family Practice 36 no. 1 (January 1993): 97-104.

Paulman, Paul M., and Abdul Sadat. "Pseudocyesis." Journal of Family Practice 30 no. 5 (May 1990): 575-582.

OTHER

Aldrich, Knight, M.D. "Sixteenth-Century Psychosomatics." Psychiatric News. April 16 1999 (cited 15 March 2002). <www.psych.org/pnews/99-04-16/history.html> .

Tish Davidson, A.M.



User Contributions:

Kelly
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Dec 24, 2007 @ 8:20 pm
i believe i am going through this right now..
and it kinda scares me,
i have all the symptoms of being pregnant,
and i feel "movements" inside me that feel like a baby kicking..
[[i have been pregnant before so yes i do know what it feels like."
but i have taken a million and 1 pregnancy tests and they all come out negative.
so im going to bring this up to my doctor when i have my next appointment in 2 weeks.
this is very very strange.
Ammar
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Mar 20, 2008 @ 3:03 am
this is an intrestting topic ...but the most wear point in in is the etiology ,it needs more research
aya
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Oct 28, 2009 @ 3:03 am
In the case of Pseudocyesis, is it possible to have a positive pregnancy test.?
Andreina
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Nov 30, 2009 @ 11:11 am
this article freaked me out because im almost convinced im going thru this. i have morning sickness almost everyday but i know im not pregnant. also i feel as thou im gaining weight and that my stomach is growing as if i were to be pregnant. this is scary. what can be done in order to treat this?
Kim
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Feb 16, 2014 @ 1:13 pm
I would like to know more about this. I recently went through this and my marriage has fallen apart bc of it. My husbands family hates me and feels I have lied about the pregnancy and are encouraging him to divorce me. I have been labeled and my life has been destroyed. I am going through counseling and pray every day for help getting through this. I need help figuring out how to explain this to his family bc all this hatred is horrible.
theresa
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May 30, 2014 @ 4:16 pm
My friend has this. Its been confirmed there is no baby. She is lactating, she looks about 7 months pregnant, tender breasts and cravings. What is going on!! She knows she is NOT pregnant.

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