Pseudocyesis (phantom pregnancy): characteristics and diagnosis

The DSM V (2013) places pseudocyesis within somatic symptom disorders and related disorders. Specifically within “Other specified somatic symptom disorders and related disorders.”

It is defined as a “false belief of being pregnant that is associated with signs and symptoms of pregnancy” (DSM V, 2013, p. 327).

It has also been called pseudopregnancy, phantom pregnancy, hysterical pregnancy and false pregnancy, although some of these are no longer used (Azizi & Elyasi, 2017).

Main characteristics and diagnosis

Symptoms presented

Among the physiological symptoms that are usually reported in cases of pseudocyesis we find: irregular menstruation, distended abdomen, subjective sensation that the fetus is moving, secretion of milk, changes in the breasts, darkening of the areola, weight gain, galactorrhea, vomiting and nausea, changes in the uterus and cervix and even labor pains (Azizi & Elyasi, 2017; Campos, 2016).

Prevalence

Much of the data reported by one review is from infertile and perimenopausal women between 20 and 44 years of age. 80% were married. It is rarely observed in postmenopausal women, men, adolescents or children (Azizi & Elyasi, 2017).

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Etiology

Its etiology is unknown, although it is thought that neuroendocrine, physiological, psychological, social, and socio-cultural factors may be involved (Azizi & Elyasi, 2017).

Physiological factors

The following conditions have been related to pseudocyesis (Azizi & Elyasi, 2017):

  1. Certain types of organic brain or neuroendocrine pathologies.
  2. Recurrent abortions
  3. Threat of menopause
  4. Sterilization surgery
  5. Uterine or ovarian tumors
  6. Cystic ovaries
  7. Uterine fibroids
  8. Morbid obesity
  9. Urinary retention
  10. Ectopic pregnancy
  11. CNS tumors
  12. History of infertility
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Psychological factors

The following disorders and situations have been related to pseudocyesis:

  1. Ambivalence regarding the desire to be pregnant, the desire to have a child, fear of pregnancy, hostile attitudes toward pregnancy and motherhood.
  2. Challenges regarding sexual identity.
  3. Stress
  4. Grief in relation to hysterectomy.
  5. Severe deprivation in childhood
  6. Significant separation anxiety and feeling of emptiness.
  7. Child sexual abuse.
  8. Schizophrenia
  9. Anxiety
  10. Mood disorders
  11. Affective disorders
  12. Personality disorders

Social factors

Among the social aspects that may be related to pseudocyesis have been documented: low socioeconomic status, living in developing countries, limited education, history of infertility, having an abusive partner, and a culture that places great value on motherhood ( Fields, 2016).

Differential Diagnosis

The DSM V (2013) differentiates pseudocyesis from the illusion of pregnancy observed in psychotic disorders. The difference is that in the latter there are no signs and symptoms of pregnancy (Gul, Gul, Erberk Ozen & Battal, 2017).

Conclusion

Pseudocyesis is a specified somatic disorder where the person firmly believes that they are pregnant and even presents certain physiological signs.

Not much is known about the etiology of the disorder, according to a review; there are no longitudinal studies on the subject because the number of patients is low. Most of the information available comes from case reports (Azizi & Elyasi, 2017).

Bibliographic references:

Azizi, M. & Elyasi, F. (2017), Biopsychosocial view to pseudocyesis: A narrative review. Recovered from:

Campos, S. (2016) Pseudocyesis. recovered from:

American Psychiatric Association., Kupfer, DJ, Regier, DA, Arango López, C., Ayuso-Mateos, JL, Vieta Pascual, E., & Bagney Lifante, A. (2014). DSM-5: Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Madrid etc.: Editorial Médica Panamericana.

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Ahmet Gul, Hesna Gul, Nurper Erberk Ozen & Salih Battal (2017): Pseudocyesis in a patient with anorexia nervosa: etiologic factors and treatment approach, Psychiatry and Clinical PsychopharmacologyDOI: