Purpose: Delusions of pregnancy are associated with functional impairment and psychological distress Previous works have focused on characterizing their etiology and identifying contributory social and cultural factors The purpose of this review is to give an overview of the literature on medical or surgical comorbidities associated with delusions of pregnancyMethods: We searched Google Scholar, PubMed, and PsycInfo using the terms "pregnancy delusion," "delusional pregnancy," "pseudocyesis", and "false/pseudo/phantom/spurious pregnancy" to identify all published cases of delusional pregnancies We included cases in which medical or surgical factors might have contributed to the delusion We extracted the following information from selected case reports: patient age, psychiatric diagnoses, medications, medical comorbidities, somatic complaints, treatment, and outcomeResults: We found that 23 of 140 cases (164%) were potentially influenced by concomitant medical or surgical conditions including gallstones, abdominal tumors, hyperprolactinemia, constipation, a tubal cyst, and esophageal achalasia Medical or surgical treatment was pursued in 15 of these 23 cases, followed by mitigation of the delusion in ten casesConclusions: We emphasize the importance of a thorough workup including physical and gynecological examinations in patients presenting with a delusion of pregnancy Clinicians should recognize and overcome potential barriers to undertaking comprehensive assessments in order to prevent delays in management and treatment of underlying medical or surgical conditions

Medical considerations in delusion of pregnancy: a systematic review.

Delusion of pregnancy is defined as a persistent belief that one is pregnant despite concrete evidence to the contrary. Despite being reported as an isolated event, delusion of pregnancy has been reported in many patients with underlying psychiatric conditions such as schizophrenia, bipolar disorder, psychotic depression, and other physiological disorders of mental function. This case study reports a case of a 44-year-old, drug-naïve female with delusion of pregnancy affected by paranoid schizophrenia. Pharmacological treatments are frequently insufficient in controlling this condition and are often supplemented with adjunctive psychotherapy.

https://doi.org/10.1177/11795476231161169

Delusion of Pregnancy: A Case Report and Literature Review

Abnormal eating behaviour among psychiatric patients is associated with several psychiatric conditions, but may also be caused by a comorbid physical condition. Clinical assessment of a psychiatric patient is often challenging, which contributes to an increased rate of undiagnosed medical conditions and an increased mortality rate. We present the clinical case of a 46-year-old woman with a long-term delusion of triplet pregnancy, and recurrent vomiting. She experienced intense weight loss and eventually faced a life-threatening situation due to achalasia, which was incidentally discovered on a chest X-ray during her second psychiatric hospitalization, after several other tests, including upper digestive endoscopy, returned normal results. After a successful laparoscopic Heller's myotomy, her digestive symptoms greatly improved. This report illustrates the difficulty of establishing clinical-surgical diagnoses in psychotic patients, as some delusions seem to explain clinical complaints, masking and delaying the diagnosis of comorbid conditions.

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Rafael Dias Lopes

Papers

Pregnancy delusion hinders the diagnosis of achalasia in a patient with life-threatening emaciation