[Recurrent pseudocyesis with polydipsia: a case report]. / Grossesse délirante récurrente avec polydipsie: à propos d'un cas.

INTRODUCTION: Pseudocyesis is an imaginary pregnancy resulting from a strong desire or need for motherhood. 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. A woman may believe in her pregnancy to the point of delusion and show acute depression when no baby is born. CASE-REPORT: This report describes a case of recurrent pseudocyesis and polydipsia in a 49-year-old woman. She was an illiterate housewife who had been married since she was 21 years old. Four years later, she divorced because of a problem of sterility. She got remarried, five years later, and the couple had no child. The patient was admitted into the Obstetric Unit thinking that she was about to give birth. She presented all the symptoms of true pregnancy. She had abdominal distension, amenorrhea, mammary tension, nausea and vomiting, and weight gain. She claimed to have felt foetal movements. Other than this, she exhibited a polydipsia syndrome. These symptoms had evolved over 20 months. The patient had previously presented six similar episodes. All these episodes were identical. The length of these episodes varied between three and five months, after which all the signs disappeared progressively. The patient had never consulted for these symptoms before the present episode. During her stay in the Obstetric Unit, she benefited from a complete gynaecological examination, including pelvic ultrasound examinations, and laboratory tests, notably hormone assays (FSH, LH, prolactin, ss-HCG) and serum electrolyte levels. A primary sterility and menopause were confirmed. Otherwise, the psychiatric assessment confirmed the delusion of pregnancy and the presence of a depressive syndrome. The patient reported that she was possessed. She explained the normality of the imagery and laboratory tests by the intervention of the demons that hid the foetus and modified the results. DISCUSSION: The contribution of psychological and physiological factors in the development of the delusion of pregnancy, possession and polydipsia, and the possible interactions between the two phenomena are discussed.

Depression in mothers of burned children.

UNLABELLED: The treatment of burned children needs to address also their psychic state. Since the child's emotional state depends heavily on the emotional state of its parents, especially the mother's, interest should also be focused on diagnosing and treating secondary psychiatric disorders in mothers of burned children. The AIM of this work was to study the prevalence of depression in mothers of burned children and its predicting factors. METHODS: The enrolment of mothers of burned children was done in the Burns Department, Ibn Rushd University Hospital in Casablanca, Morocco. Twenty-eight mothers of seriously burned children agreed to participate in this study. A psychiatric interview was conducted after informed consent was obtained. The mothers completed a questionnaire; the diagnosis was made according to DSM IV criteria using the Mini International Neuro-psychiatric Interview (MINI). The Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were used to evaluate respectively the intensity of depression and the level of anxiety. Social functioning was assessed by the Global Assessment of Functioning scale (GAF). The minimum time interval between the child's being burned and the interview with the mother was one month. RESULTS: The prevalence of depression was 35.7%, which is much higher in the mothers of burned children as compared to the general population. Several risk factors were found such as: several burned children or burn of the only child, severity and complications of burn, and the socio-economic level. CONCLUSION: Depression is a common disorder in mothers of burned children. Thus early screening for depression in mothers and psychological and psychiatric support must be provided in conjunction with the treatment of the burned child.

Post-traumatic stress disorder in burned patients.

UNLABELLED: The essential feature of post-traumatic stress disorder is the development of characteristic symptoms following exposure to a traumatic stressor involving direct personal experience of an event that involves threat of death oactual r serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (DSM IV). The aim of this work is to assess the prevalence of post-traumatic stress disorder (PTSD) among the burned victims and its predicting factors. METHODS: Patients were recruited at the Burns Department in the Ibn Rushd University Hospital during the period between 1 October 1998 and 1 October 1999. All patients were psychiatrically interviewed and answered a questionnaire. The diagnosis of PTSD was done according to DSM IV criteria. Results were analyzed on Epi info software. RESULTS: Sixty patients gave their consent to participate in this study. The 23.3% met criteria for PTSD and 55% for major depressive disorder. In short, PTSD was related to age, explosion of gas containers for cooking purposes, depression and low social functioning. Otherwise, no relationship was found between PTSD and gender, length of hospitalization or severity of burn. CONCLUSION: Post-traumatic stress disorder remains a poorly known entity by clinicians and under-diagnosed in burned patients. Considering the frequency of this pathology, an anti-depressant treatment and a psychotherapeutic relationship are necessary to improve the health and the quality of life of these patients.