Psychosomatic symptoms of the Couvade syndrome in Finnish and Polish expectant fathers.

OBJECTIVES: The aim of the study was to assess the occurrence of symptoms associated with the Couvade syndrome in two groups of men of Polish and Finnish nationality, and to perform a comparative analysis. MATERIAL AND METHODS: The study was conducted in two groups of men (expectant fathers): 51 Poles and 40 Finns using a self-constructed questionnaire prepared in Polish and English languages. The statistical analysis was performed in Micro-soft Office Excel 2010 and Statistica 12. The Pearson's test was calculated, and the statistical significance level was p < 0.05. RESULTS: The most common physical symptoms reported by the Polish men were weight gain (78%) and gastric disorders (80%), whereas the Finns most frequently declared weight gain (60%). As for emotional symptoms, mood swings (p = 0.0001) and sleep disorders (p = 0.00004) were significantly more common in the Poles, whilst the Finns experienced frustration (p = 0.0403) and nervousness (p = 0.01579) significantly more frequently. The Finnish respondents more often used profes-sional forms of preparation for childbirth and parenthood (p = 0.00229). CONCLUSIONS: Psychosomatic symptoms of the Couvade syndrome are significantly more common in Polish than in Finnish expectant fathers. Compared with Polish fathers, Finns significantly more frequently attend ante-natal classes. Ante-natal care should encompass education of men as they do experience the symptoms of the Couvade syndrome during their wives'/partners' pregnancies.

Psychosomatic disorders of gravida status: false and denied pregnancies.

OBJECTIVE: The authors review the literature on two dramatic psychosomatic disorders of reproduction and offer a potential classification of pregnancy denial. METHOD: Information on false and denied pregnancies is summarized by comparing the descriptions, differential diagnoses, epidemiology, patient characteristics, psychological factors, abdominal tone, and neuroendocrinology. Pregnancy denial's association with neonaticide is reviewed. RESULTS: False and denied pregnancies have fooled women, families, and doctors for centuries as the body obscures her true condition. Improvements in pregnancy testing have decreased reports of false pregnancy. However, recent data suggests 1/475 pregnancies are denied to 20 weeks, and 1/2455 may go undiagnosed to delivery. Factors that may contribute to the unconscious deception include abdominal muscle tone, persistent corpus luteum function, and reduced availability of biogenic amines in false pregnancy, and posture, fetal position, and corpus luteum insufficiency in denied pregnancy. For each condition, there are multiple reports in which the body reveals her true pregnancy status as soon as the woman is convinced of her diagnosis. Forensic literature on denied pregnancy focused on the woman's rejection of motherhood, while psychiatric studies have revealed that trauma and dissociation drive her denial. CONCLUSIONS: False pregnancy has firm grounding as a classic psychosomatic disorder. Pregnancy denial's association with neonaticide has led to misleading forensic data, which obscures the central role of trauma and dissociation. A reappraisal of pregnancy denial confirms it as the somatic inverse of false pregnancy. With that perspective, clinicians can help women understand their pregnancy status to avoid unexpected deliveries with tragic outcomes.

Delusion of pregnancy associated with antipsychotic induced metabolic syndrome.

Metabolic syndrome is currently the research topic of several studies. Although physical manifestations of metabolic syndrome have been described, the psychological and psychiatric impact of metabolic syndrome has not been studied to date. We report the first case of antipsychotic-induced metabolic syndrome which was associated with development of delusions of pregnancy in a post-menopausal woman.

Pseudocyesis.

Pseudocyesis - a clinical syndrome seen in non-psychotic woman, known since the time of Hippocrates. Pseudocyesis has a psychological basis in which a woman's wish for pregnancy is essential to their identity and self-esteem. Normally, pseudocyesis is seen in women who desperately want to become pregnant, especially those with longstanding infertility. Basically, the treatment of Pseudocyesis is to help these patients recognize the illness and to educate and counsel them. Here is the case of pseudocyesis in which there is no history of long standing infertility. This case is rare and liable to be missed.

Delusion of pregnancy in frontotemporal lobar degeneration with motor neurone disease (FTLD/MND).

Psychotic phenomena such as delusions and hallucinations are rare in frontotemporal dementia syndromes but have recently been recognised as an early feature in some cases of frontotemporal lobar degeneration with motor neurone disease (FTLD/MND). A patient with delusion of pregnancy as an early feature of FTLD/MND is presented to illustrate the need to consider neurodegenerative disease as well as primary psychiatric disorder as the underlying cause of this striking symptom.

[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.

Antipsychotic-induced hyperprolactinemia and delusion of pregnancy.

The authors describe 12 patients with antipsychotic-induced hyperprolactinemia. Six patients had erroneous ideas of being pregnant (four delusional and two non-delusional) temporally associated with hyperprolactinemia and resolving as prolactin levels returned to normal. The remaining six patients did not develop such ideas. Contrasting the clinical features of the two groups of patients in the context of existing literature informs on the possible biological and cognitive mechanisms that can be hypothesized to underlie the relationship between hyperprolactinemia due to antipsychotics and the development of inaccurate beliefs and feelings about pregnancy, and the effect of current mental state on the propensity to develop these beliefs.

Hyperprolactinemia and delusion of pregnancy.

We describe the case of a 44-year-old woman admitted with mania with psychotic symptoms who presented with delusion of twin pregnancy a month after admission, which temporally correlated with hyperprolactinemia secondary to antipsychotic medication. Modification of antipsychotic medication was associated with fall in serum prolactin and disappearance of delusion of pregnancy. In light of this clinically striking temporal association between hyperprolactinemia and delusion of pregnancy, we review the literature to examine the hypothetical relationship. We highlight the clinical significance of examining the various factors, including antipsychotic-induced hyperprolactinemia, which could trigger the development of delusion of pregnancy.

Delusional pregnancy in a patient with primary sterility.

The case of a patient suffering from primary sterility who developed a well-systemized delusion of pregnancy is described. The patient did not have a history of psychiatric disorder or organic cerebral pathology. No history of epilepsy was detected in this patient contrary to the reports in the literature, and these facts have pathogenic relevance in delusional pregnancy. The importance of psychological factors in the development of a delusion of pregnancy is discussed.

Pseudocyesis in an adolescent using the long-acting contraceptive Depo-Provera.

PIP: A case report documents a Hispanic adolescent, 17 years of age, with pseudocyesis, who became amenorrheic using Depo-Provera to prevent a second pregnancy. Pseudocyesis includes classic symptoms of pregnancy such as nausea, breast enlargement and pigmentation, abdominal distention, and amenorrhea in nonpregnant women. It demonstrates the to control one's physical aspect at the level of hypothalamus. The involvement that contributed to her pseudocyesis--in this case, of her mother and boyfriend -- was not unusual. The abrupt resolution was brought on by normal menstrual period that began after she voluntarily missed her Depo-Provera injection. However, her ambivalence about a pregnancy became clear after she and her family received counseling. While the agenda had been to help her prevent a pregnancy, hers had not been as clear and uncomplicated. Her subsequent conception was a very positive one for her and her family, which helped to resolve the situation.^ieng

Effects of oestrogen supplementation and space restriction on PGF2alpha-induced nest-building in pseudopregnant gilts.

This study examined the role of oestrogen supplementation on PGF2alpha-induced nest-building in pseudopregnant gilts. Oestradiol valerate (5 mg/day) injections were given on Days 11-15 of the oestrous cycle to induce pseudopregnancy. A further series of injections of either oestradiol valerate (5 mg/day) or vehicle were given on days 44-46 of pseudopregnancy to reflect more closely the hormone profile seen in pregnancy. Nest-building was induced by a single intramuscular injection of 15 mg of PGF2alpha (Lutalyse) on Day 47 of pseudopregnancy. The gilts were housed in pens (2.8 x 1.7 m) containing straw in experiment 1 or chronically confined in crates (0.6 x 1.7 m) that did not contain straw on days 44-48 of pseudopregnancy for experiment 2. Oestrogen supplemented gilts had significantly higher concentrations of circulating 17beta-oestradiol on day 47 of pseudopregnancy but there were no significant differences between treatments for circulating levels of prolactin, progesterone, cortisol or oxytocin, or for any behavioural measure in either experiment. These results indicate that there is no direct effect of supplementing already pseudopregnant gilts with oestradiol valerate on PGF2alpha-induced nest-building. The results also show that the pre-partum environment has a pronounced effect on nest-building behaviours and that non-pregnant pigs might be a useful model for pre-partum nest-building in this species.