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腹腔三胎妊娠妄想:一例病例报告并文献复习

Delusion of Triplet Pregnancy in Abdominal Cavity: A Case Report with a Review of Literature.

作者信息

Goyal Shri Gopal, Mahapatra Ananya, Goyal Priti Kumari, Khandelwal Sudhir Kumar

机构信息

Department of Psychiatry (DIMHANS), PBM Hospital, SP Medical College, Bikaner, Rajasthan, India.

Department of Psychiatry, AIIMS, New Delhi, India.

出版信息

Indian J Psychol Med. 2017 Jul-Aug;39(4):509-511. doi: 10.4103/0253-7176.211749.

Abstract

The two terms, pseudocyesis and delusion of pregnancy, were frequently used for pseudopregnancy. Delusion of pregnancy is a special form of hypochondriacal/somatic delusion reported in various psychiatric and organic disorders. The origin of the delusion of pregnancy in schizophrenia has often been explained by psycho-analytic interpretations attributing wish fulfilling, protective role to false beliefs, and mother establishes an undisturbed union with her fetus during pregnancy, which eliminate loneliness and helplessness. The current case is a 49-year-old married female with an illness of total duration of 10 years. Initial symptoms were delusion of infidelity and persecution and 2 and 3 person auditory hallucination; however, the patient started reporting around 2 years back that she was pregnant and there were three female children inside her abdominal cavity rather than in uterus. She was firm on this belief and was not convinced by family members even giving evidence contrary to her belief like showing ultrasonography report. She firmly believed that these are gift of God, and they are special children who would be delivered through special procedure. Blood investigation revealed raised prolactin level, blood sugar and ultra sonography suggestive of cholelithisis. Patient's psychiatric symptoms including delusion of pregnancy were significantly improved with treatment, and medical and surgical comorbidities were managed with appropriate consultations.

摘要

“假孕”和“妊娠妄想”这两个术语经常用于指代假性怀孕。妊娠妄想是一种特殊形式的疑病性/躯体性妄想,在各种精神疾病和器质性疾病中均有报道。精神分裂症中妊娠妄想的起源通常用精神分析解释来阐释,即将愿望实现、保护作用归因于错误信念,且母亲在怀孕期间与胎儿建立了不受干扰的联系,这消除了孤独感和无助感。本病例是一名49岁已婚女性,病程长达10年。初始症状为不忠妄想、迫害妄想以及二三个人的幻听;然而,患者大约在两年前开始称自己怀孕了,且腹腔内有三个女儿而非子宫内。她坚信这一信念,即使家人出示超声检查报告等与她的信念相悖的证据,她也不为所动。她坚信这些是上帝的恩赐,她们是特殊的孩子,将通过特殊程序分娩。血液检查显示催乳素水平升高、血糖升高,超声检查提示有胆结石。患者的精神症状包括妊娠妄想经治疗后有显著改善,同时通过适当会诊对内科和外科合并症进行了处理。

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