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Pseudocyesis: When You Think You’re Pregnant, Have Pregnancy Symptoms, But Aren’t Pregnant

A Canadian man who thought he was going to be the father of quintuplets was surprised to find out his girlfriend was never actually pregnant at all, despite lactation and signs of stomach swelling, according to news reports.

CTV reported that the girlfriend may have had a condition called pseudocyesis, or false or phantom pregnancy; she is currently being psychiatrically evaluated.

People with pseudocyesis think that they are pregnant and even exhibit physical symptoms of pregnancy — but they are not actually pregnant at all. It’s currently included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the “Not Elsewhere Classified” section, under Somatic Symptom Disorders. However, it’s been around for many years — a 1941 article in the New England Journal of Medicine, for instance, described is as “an affliction of queen and commoner with reverberations in many fields from domestic to theological.”

WebMD reports that anywhere from one to six cases of every 22,000 live births involves pseudocyesis.

According to the DSM-5, pseudocyesis is defined as “a false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy, which may include abdominal enlargement, reduced menstrual flow, amenorrhea, subjective sensation of fetal movement, nausea, breast engorgement and secretions, and labor pains at the expected date of delivery.”

A 2013 article in the journal Reproductive Biology and Endocrinology noted that currently, most cases of pseudocyesis occur in undeveloped countries, where a woman might receive medical care later in the pregnancy than a woman would in developed countries (where visits to the obstetrician often take place in the first trimester).

The same article also evaluated published studies on pseudocyesis, and identified 10 women with the condition to deduce commonalities between them. The researchers found “that pseudocyetic women share many endocrine traits with PCOS [polycystic ovary syndrome] and major depressive disorder, although these traits are more akin to PCOS than to major depressive disorder,” they wrote in the study.

They also noted that the studies included in the review suggest women with pseudocyesis may have more activity in their sympathetic nervous systems, as well as some other brain differences that could explain the pregnancy-associated symptoms:

The reviewed data support the notion that pseudocyetic women may have: increased sympathetic nervous system activity; dysfunction of central nervous system catecholaminergic pathways involved in the regulation of hormone secretion from adenohypophysis; and decreased steroid feedback inhibition of GnRH. These neuroendocrine/endocrine disorders may cause hypomenorrhea or amenorrhea, galactorrhea, diurnal and/or nocturnal hyperprolactinemia, abdominal distension and apparent fetal movements and labor pains at the expected date of delivery – traits exhibited by most pseudocyetic women. However, other neuroendocrine/endocrine pathways not yet analyzed in pseudocyetic women may also be involved in the development of pseudocyetic traits.

According to a 2008 article in the Indian Journal of Psychiatry, there are three psychological factors that seem to play a role in pseudocyesis. They include: the desire for, or fear of, pregnancy; mistaking sensory stimuli (like a distended abdomen) as a sign of pregnancy; and the result of neuroendocrine changes that seem to accompany depressive disorder.

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