School of Medicine, Baylor College of Medicine, Houston, TX, USA.
Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
J Psychosom Obstet Gynaecol. 2022 Mar;43(1):51-57. doi: 10.1080/0167482X.2020.1779696. Epub 2020 Jun 29.
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 pregnancy.
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 outcome.
We found that 23 of 140 cases (16.4%) 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 cases.
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.
妊娠妄想与功能障碍和心理困扰有关。以前的研究集中在描述其病因和确定促成的社会和文化因素。本综述的目的是概述与妊娠妄想相关的医学或手术合并症的文献。
我们使用“妊娠妄想”、“妄想妊娠”、“假性妊娠”和“假/伪/幻/假妊娠”等术语在 Google Scholar、PubMed 和 PsycInfo 上进行搜索，以确定所有已发表的妊娠妄想病例。我们纳入了可能导致妄想的医学或手术因素的病例。我们从选定的病例报告中提取了以下信息：患者年龄、精神科诊断、药物、合并症、躯体症状、治疗和结局。
我们发现，在 140 例病例中，有 23 例（16.4%）可能受到伴随的医学或手术情况的影响，包括胆结石、腹部肿瘤、高催乳素血症、便秘、输卵管囊肿和食管失弛缓症。在这 23 例病例中，有 15 例接受了医学或手术治疗，随后 10 例妄想得到缓解。
我们强调在出现妊娠妄想的患者中进行全面检查的重要性，包括身体和妇科检查。临床医生应认识到并克服进行全面评估的潜在障碍，以防止对潜在的医学或手术疾病的管理和治疗的延误。
