INTRODUCTION:

Because pseudocyesis involves complex interactions between psychological and physiological factors, it presents a considerable treatment problem. Though uncommon, the condition's significant effects on those who are afflicted demand further investigation. Pseudocyesis, sometimes referred to as false pregnancy or phantom pregnancy, is an uncommon psychological disorder in which a person presents with pregnancy-related symptoms but is not actually pregnant. For ages, the phenomenon has captivated medical specialists, and understanding its diverse aspects is crucial for researchers and medical professionals alike.¹

Definition: Pseudocyesis, also known as phantom pregnancy or false pregnancy, is a psychophysiological disorder in which a person displays pregnancy-related symptoms and signs even if there isn't a viable fetus¹.

Historical Context of Pseudocyesis:

Pseudocyesis is a phenomenon that has been recorded historically, with allusions originating from prehistoric times. For instance, medical records from ancient Egypt reported situations of women displaying pregnancy signs but without really becoming pregnant². In a similar vein, situations resembling pseudocyesis were also mentioned in ancient Greek and Roman sources. Pseudocyesis was misunderstood as a supernatural or mystical phenomenon during the Middle Ages and Renaissance due to ideas about fertility and reproductive health that frequently resulted in myths and superstitions regarding pregnancy.

Medical professionals started to more closely examine cases of pseudocyesis in the 17^th and 18th centuries. Early medical literature frequently referred to pseudocyesis as "hysterical pregnancy" or "spurious pregnancy," which reflected the prevalent etiological beliefs at the time. However, pseudocyesis was not more precisely understood as a psychophysiological phenomena until the development of contemporary psychiatry and advances in reproductive medicine.³

With the advancement of medical knowledge in the 19^th and 20^th centuries, pseudocyesis was increasingly acknowledged as a psychological disorder as opposed to a strictly physiological one. Healthcare practitioners now have a greater grasp of the numerous elements that contribute to pseudocyesis, such as the involvement of psychological stressors, underlying mental illnesses, and neuroendocrine pathways, thanks to the introduction of diagnostic criteria and clinical recommendations³. Even though pseudocyesis is still a very uncommon disorder, research on it is still being done in the fields of psychiatry, psychosomatic medicine, and reproductive health.

Psychological Pathophysiology Factors are:

1. Psychological factors - (stress, trauma, desire for pregnancy etc)

2. Psychological distress and coping

3. Activation of stress response system (HPA axis)

4. Release of stree hormone i.e cortisol, etc

5. Impact on Reproductive physiology

6. Disruption of menstrual cycle (amenorrhea)

7. Physical symptoms of Phantom pregnancy

8. (Abdominal enlargement, breast tenderness etc)⁴

Physiological Pathological Factors are:

1. Neuroendocrine changes, hormonal alteration, brain body interaction etc.

2. Neuroendocrine changes and hormonal imbalance

3. Alteration in hormone levels (e.g prolactin, estrogen, progesterone)

Causes:

· Myriad factors like (including psychosocial stressors or unresolved reproductive issues and cultural factors⁴.

· History of individual infertility

· History of recurrent pregnancy loss

· Societal expectation towards motherhood

· Fertility can exacerbate the psychological distress associated with pseudocyesis

Symptoms:

· Breast tenderness.

· Enlarged abdomen.

· Missed menstrual period.

· Weight gain.

· Nausea or morning sickness.

· Food cravings or aversions.

· False labor contractions.

Preventive Measures:

Preventive measures for pseudocyesis primarily focus on:

Addressing underlying psychological Causes and providing comprehensive reproductive healthcare⁴.

Timely identification and management of psychosocial stressors, coupled with education on reproductive health and family planning, can mitigate the risk of developing pseudocyesis⁵.

Treatment:
Pseudocyesis treatment is a comprehensive approach that includes supportive care, medication, and psychological counseling⁶. Psychoeducation and cognitive-behavioral therapy (CBT) can assist people in comprehending and managing the psychological elements that contribute to pseudocyesis. Antidepressants and anxiolytics are examples of pharmacological therapies that can be used to treat related symptoms.⁷

Psychological Aspect:

pseudocyesis on affected individuals requires a knowledge of its psychological component. The intense emotional commitment to the idea of pregnancy, together with the disappointment and uncertainty that follow after learning of the diagnosis⁹ highlight the importance of receiving compassionate and understanding psychological assistance.

Prognosis:

The likelihood of recovery from pseudocyesis varies based on the patient's psychological fortitude, availability of resources for assistance, and reaction to therapy⁸. Many people find symptom relief and a gradual reintegration into their everyday life with the right assistance and counseling⁹. However, continuous therapy support may be required if psychological suffering persists.

CONCLUSION:

In conclusion, a comprehensive approach to diagnosis and treatment is crucial since pseudocyesis is a result of the intricate interaction of psychological and physiological elements. Healthcare practitioners can successfully help persons experiencing pseudocyesis and lessen its emotional burden by explaining the psychophysiological mechanisms, identifying potential causes, and adopting comprehensive treatment procedures.

REFERENCES:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

2. Stein, D. J., Koen, N., Donald, K. A., Adnams, C. M., Koopowitz, S., Lund, C., and Rotheram-Borus, M. J. (2014). Investigating the psychosocial determinants of Child health in Africa: The Drakenstein Child Health Study. Journal of Neuroscience Methods. 236, 114-125.

3. Arnold, L. M. Psychogenic infertility. Seminars in Reproductive Medicine.2013; 31(4): 312-316.

4. https://www.google.com/search?q=psychopathological+factor+of+phantom+pregnancyandoq=psychopathological+factor+of+phantom+pregnancy andgs_lcrp=EgZjaHJvbWUyBggAEEUYOTIJCAEQIRgKGKAB0gEJMjYzMjhqMGo3qAIAsAIAandsourceid=chromeandie=UTF-8

5. Duddu, V., Husain, N., Dickens, C., and Walker, I. Pseudocyesis: clinical aspects and historical perspectives. Transcultural Psychiatry. 2007; 44(1): 115-132.

6. Mawaldi, L., Khayat, W., and O'Brien, P. The psychological roots of pseudocyesis: a comprehensive review. Journal of Psychosomatic Obstetrics and Gynecology. 2015; 36(3): 82-89.

7. Pascoe, R. The phantom pregnancy: the power of the human mind. Australian and New Zealand. Journal of Obstetrics and Gynaecology. 2012; 52(3): 220-222.

8. Stotland, N. L. Psychological aspects of obstetric care. In Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice (pp. 59-67). Philadelphia, PA: Elsevier Saunders. 2015

9. Lopata, H. Z., and Toth, T. L. A history of ectopic pregnancy. In Ectopic Pregnancy: A Clinical Casebook (pp. 3-14). New York, NY: Springer. 2012

10. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 193: Tubal ectopic pregnancy. Obstetrics and Gynecology. 2018; 131(2): e91-e103.

Received on 05.03.2024 Modified on 29.05.2024

A and V Pub J. of Nursing and Medical Res. 2024; 3(3):115-117.

DOI: 10.52711/jnmr.2024.27