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Pseudocyesis

Pseudocyesis

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 (5698% 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 humansmost 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.

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pseudocyesis

pseudocyesis (sōō´dōsīē´sĬs), imaginary pregnancy in women usually resulting from a strong desire or need for motherhood. In the absence of conception, the menstrual periods nevertheless cease, the abdomen becomes enlarged and the breasts swell and even secrete milk, mimicking genuine pregnancy. The uterus and cervix may show signs of pregnancy, urine tests may be falsely positive, and the woman may report sensations of fetal movements. A woman may believe in her pregnancy to the point of delusion and show acute depression when no baby is born. It has been suggested that depression can sometimes alter the activity of the pituitary gland so as to cause hormone level changes that mimic the hormone changes of real pregnancy.

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phantom pregnancy

phantom pregnancy or pseudocyesis, is a well-known phenomenon to dog owners. It may be observed also in humans, though rarely. Women with phantom pregnancies stop having periods, have enlarged breasts and a distended abdomen, and may complain of nausea. It may be more common in cultures in which there are especially strong social pressures on women to produce babies.

J. Newsom-Davis

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pseudocyesis

pseudocyesis (phantom pregnancy) (s'yoo-doh-sy-ee-sis) n. a condition in which a nonpregnant woman exhibits symptoms of pregnancy, e.g. enlarged abdomen, morning sickness, and absence of menstruation. The condition usually has an emotional basis.

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phantom pregnancy

phantom pregnancy n. see pseudocyesis.

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Pseudocyesis

Pseudocyesis

Definition

Description

Signs and symptoms

Causes

Demographics

Prognosis

Resources

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 twice 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. She retired to her chambers for 14 months for the first false pregnancy, only to emerge humiliated, without a child. On the second occasion, the cause of her symptoms may have been advanced ovarian cancer, which some medical historians believe eventually killed her.

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 the natural signs of pregnancy such 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, and 63–97% of women with pseudocyesis experience it. 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 with the disorder 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. In addition, some women actually test positive on pregnancy tests.

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

KEY TERMS

Cervix —The neck or narrow lower end of the uterus. Softening of the cervix is one of the signs of pregnancy.

Distension —The condition of being stretched or expanded, as the abdomen of a pregnant woman.

Quickening —A term that refers to the movements or other signs of life of a fetus in the womb.

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 six-and-a-half 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. Although pseudocyesis is overwhelmingly a disorder of females, there have been at least three reported cases of males with it. Pseudocyesis is found in some mammals other than humans, most often cats, dogs, and rabbits. In these animals, researchers have found that prolactin, the hormone that produces mammalian milk, plays a role in the development of the false pregnancy.

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. At the same time, however, it is important for the treating professional not to minimize the reality of the patient’s physical symptoms.

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

Alternative therapies

There have been reports of patients being cured of pseudocyesis by hypnosis, purgatives, massage, opioids, or by experiencing “hysterical childbirth” after nine months of symptoms, but few data are 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. Treatments involving psychotherapy have high success rates, as they treat 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., and Douglas M. Hoy. “Pseudocyesis in an Adolescent Incest Survivor.”Journal of Family Practice 36.1, (Jan. 1993): 97–104.

Paulman, Paul M., and Abdul Sadat. “Pseudocyesis.” Journal of Family Practice 30.5, (May 1990): 575–82.

OTHER

Aldrich, Knight, MD. “Sixteenth-Century Psychoso-matics.” Psychiatric News. April 16, 1999. www.psych.org/pnews/99-04-16/history.html

Tish Davidson, A.M.

Emily Jane Willingham, PhD

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"Pseudocyesis." The Gale Encyclopedia of Mental Health. . Encyclopedia.com. (September 21, 2018). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/pseudocyesis

"Pseudocyesis." The Gale Encyclopedia of Mental Health. . Retrieved September 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/pseudocyesis

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Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

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American Psychological Association

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Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.