Pregnant Without a Uterus: A Case of Pseudocyesis Preceding Psychosis

Abstract

Pseudocyesis is an uncommon syndrome in which a woman firmly believes to be pregnant, and manifests signs and symptoms of pregnancy, in the absence of true gestation. A woman of 37 years of age, hysterectomized at 34 and was currently divorcing an 85-year-old vasectomized man, after engaging in an extra-conjugal relationship. Soon after, she developed signs and symptoms of pregnancy and the belief of being pregnant. After being exposed to additional stressors such as sleep deprivation, she presented for psychiatric evaluation with a psychotic episode, centered around a delusional pregnancy. She was admitted and treated with antipsychotics, which enabled full remission, matching a diagnosis of brief psychotic disorder. When the belief in pregnancy takes the form of a delusion, it is arguably easier to treat than as an overvalued idea, or pseudocyesis vera. Although little is known about prognosis, psychotherapy may play an important role in relapse prevention.