Pseudocyesis and delusional pregnancy represent rare but clinically significant presentations across psychiatric practice. While pseudocyesis involves a false belief of pregnancy accompanied by physical manifestations, delusion of pregnancy refers to a fixed belief of being pregnant despite clear contrary evidence. Both conditions pose considerable challenges as they involve close consultation and liaison between Obstetrics & Gynaecology and Psychiatry. There are a few studies from tertiary care general hospitals in India. Here we report two case series. Case 1: A 43-year-old married woman from a rural background with an 8-year history of recurrent depressive disorder and dysthymia, presented with 3 months of amenorrhea and a firm conviction of being pregnant, accompanied by sensations of fetal movement. Despite negative obstetric findings and counselling in the Obstetrics and Gynaecology (OBG) department, she insisted she was pregnant and requested termination. Psychiatric evaluation revealed depressive symptoms with a delusion of pregnancy. Case 2: A 60-year-old married homemaker from a rural area presented with 3 months of abdominal pain and persistent fetal-like sensations. Despite negative ultrasound findings, she remained convinced she was pregnant even after OBG consultation. Psychiatric referral revealed cognitive impairment consistent with early dementia, along with a delusion of pregnancy. Conclusion: These cases highlight the complex interplay between psychosocial stressors, somatic experiences, cognitive decline, and delusional beliefs related to pregnancy. Early multidisciplinary involvement and attention to the psychodynamic formulation are essential for accurate diagnosis and management.
Arora et al. (Wed,) studied this question.