A 30 year old lady visits her GP requesting support for her pregnancy. She explains that she became pregnant 6 months ago and has now started to feel the baby move. She reports last having had sex two years ago. She complains of significant nausea and abdominal pain and on examination there is some evidence of abdominal enlargement although not as much as would be expected at this stage. A pregnancy test is negative and the GP is unable to detect a foetal heart rate with a doppler scan. Which of the following do you suspect?
Pseudocyesis is a condition whereby a woman believes herself to be pregnant when she is not. Objective signs accompany the belief such as abdominal enlargement, menstrual disturbance, apparent foetal movements, nausea, breast changes, and labour pains.
Couvade syndrome is a conversion disorder seen in partners of expectant mothers during pregnancy. Symptoms mimic pregnancy and include nausea, vomiting, abdominal pain, and food cravings. It is not a delusion and those affected do not believe they are pregnant.
Pseudocyesis is a condition whereby a woman believes herself to be pregnant when she is not. Objective signs accompany the belief such as abdominal enlargement, menstrual disturbance, apparent foetal movements, nausea, breast changes, and labour pains.
Couvade syndrome is a conversion disorder seen in partners of expectant mothers during pregnancy. Symptoms mimic pregnancy and include nausea, vomiting, abdominal pain, and food cravings. It is not a delusion and those affected do not believe they are pregnant.
Delusions (types)
There are many different types of delusion. Take time to memorise this list as it will lead to easy marks in the exam.
Folie a deux - a syndrome where a delusion is transmitted from one person to another (aka a shared delusion)
Grandiose - belief that one has special powers, beliefs, or purpose
Hypochondriacal - belief that something is physically wrong with the patient
Ekboms' syndrome - belief that has been infested with insects
Othello syndrome - belief that a sexual partner is cheating on them
Capgras delusion - belief that a person close to them has been replaced by a double
Fregoli delusion - patient identifies a familiar person (usually suspected to be a persecutor) in other people they meet
Syndrome of subjective doubles - belief that doubles of him/her exist
Lycanthropy - belief that one has been transformed into an animal
De Clérambault's syndrome - false belief that a person is in love with them
Cotard's syndrome/ nihilistic delusions - belief that they are dead or not exist
Referential - belief that others/TV/radio are speaking directly to or about the patient.
Delusional perception - belief that a normal percept (product of perception) has a special meaning.
Pseudocyesis - a condition whereby a woman believes herself to be pregnant when she is not. Objective signs accompany the belief such as abdominal enlargement, menstrual disturbance, apparent foetal movements, nausea, breast changes, and labour pains.
