Hence, we present a case of a woman with pseudocyesis in the setting of bipolar disorder, specifically within a current manic episode with features of psychosis. However, very few cases have been reported in patients with bipolar disorder. Many of these cases occurred in the context of major depressive disorder and psychotic disorders. As of 2016, fewer than six hundred cases had been formally documented worldwide. Pseudocyesis is rare and occurs more in developing countries. Another differential diagnosis of pseudocyesis is factitious disorder imposed on self, defined in the DSM-5 as a category of somatic symptom disorder when a woman acknowledges being pregnant knowing that it is not true. Delusional pregnancy is common in women during the state of psychosis. It is a true somatic delusion, characterized under schizophrenia and other psychotic disorders. On the other hand, the delusion of pregnancy is defined in the DSM-5 as when a person has a fixed belief of being pregnant but in the absence of physical signs and symptoms suggestive of pregnancy and negative confirmatory tests. Pseudocyesis and its other variants should be differentiated. The presence of physical symptoms of pregnancy is unique to pseudocyesis. Confirmation of pseudocyesis is achieved with negative pregnancy testing of blood and urine, or ultrasound.
Fake pregnant test manual#
Pseudocyesis is a rare condition defined in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), as when a person has a false belief of being pregnant, accompanied by objective signs and symptoms of pregnancy, which may include abdominal enlargement, oligomenorrhea/amenorrhea, subjective sensation of fetal movement, nausea, breast engorgement, and secretions, and labor pains at the expected date of delivery, despite not being pregnant.
Fake pregnant test series#
Our patient's presentation highlights one of the few cases ever formally documented in a developed country, as most of the cases reported are found in developing countries. More studies, including case series and systematic reviews, need to be done to better understand this rare condition and its other variants. Pseudocyesis is a rare condition often associated with other psychiatric comorbidities. She was later committed involuntarily and transferred to a long-term psychiatry facility. She was restarted on her home medications, including risperidone, oxcarbazepine, and topiramate.
The patient was given olanzapine for her agitation and was subsequently stabilized with haloperidol and lorazepam. Her examination showed an obese woman, with a non-distended abdomen and non-palpable uterus with no breast tenderness or enlargement. She has a history of bipolar disorder and post-traumatic stress disorder. The patient continued to believe she was pregnant due to her symptoms, despite negative pregnancy tests on multiple occasions. She described symptoms of increasing abdominal size, whitish discharge from her nipple, and feeling of fetal movement.
The patient was found in the woods naked, with signs of psychosis. Confirmation of pseudocyesis is achieved with a negative result of beta-human chorionic gonadotropin in the blood and/or urine and negative ultrasound finding. Most cases of pseudocyesis occur in the setting of major depressive disorder or psychotic disorder, with very few occurring during a manic episode of bipolar disorder. Hence, we present a 30-year-old woman with pseudocyesis in the setting of bipolar disorder, specifically within a current manic episode with features of psychosis. Pseudocyesis is a rare condition in which a person has a false belief of being pregnant, accompanied by objective signs and symptoms of pregnancy, despite not being pregnant.