Psychosocial and cultural aspects of pseudocyesis

Abstract

Though considered rare in the developed countries, pseudocyesis is fairly common in gynecological practices in Africa. Using a case report and an overview of the literature, this paper posits that the elucidation of the psychosocial and cultural contexts within which a given patient lives can provide a basis for the empathic understanding of the reasons for the development of pseudocyesis. The case underscores the contributions of extreme poverty, relationship instability, and recurrent partner abuse in the enactment of pseudocyesis within a culture that treasures children for economic survival and generational continuity. The awareness of this cultural dimension is considered relevant to effective clinical care.

Pseudocyesis in a patient with anorexia nervosa: etiologic factors and treatment approach

“…According to the dynamic psychological component of pseudocyesis, it always occurs in the context of a wish or fear of pregnancy, emotional conflict, stress or ambivalence [13]. In this case report, emotional difficulties after losing her father may be associated with fantasies and wishes of becoming pregnant as a way of achieving love object again while the disturbed relationship with her mother causes eating disorder.…”

“…Hyperprolactianemia can result from psychological stress or can be raised by organic conditions and nipple stimulations as well as by drugs such as oestrogens, antidepressants, antihypertensives, protease inhibitors, opiates, benzodiazepines, cimetidine and dopamine blockers [5,11]. Psychosocial factors that may be implicated the development of pseudocyesis were lower socioeconomic status, lower educational attainment, emotional chaos, childhood sexual abuse, disturbed family dynamics, chronic social deprivation and ambivalence about pregnancy and loss [5,12,13] and therefore, most pseudocyetic women suffer from major depression, anxiety and/or emotional stress [3,14]. The deficit in brain dopamine and norepinephrine activity in major depressive disorder increases sympathetic nervous system activity, dysfunction of central nervous system catecholaminergic pathways and steroid feedback inhibition of gonadotropin-releasing hormone so this may be associated with hyperprolactianemia and may be a shared endocrine trait between major depression and pseudocyesis [3,15,16].…”

Pseudocyesis- A Case Report:-

“…There are even cultures in parts of the world where children are thought of as a necessity for surviving economically, so women who are under immense pressure from their partners and at times abuse as well, can be susceptible to pseudocyesis [13] [14].…”

Challenges of recognition of the psychiatric aspects of intimate partner violence

“…[76] It has also been argued that the distress associated with intimate partner violence may be involved in the enactment of a somatoform disorder like pseudocyesis in susceptible persons. [77]…”