Generality
Hysterical pregnancy (o pseudociesis) is a rare clinical syndrome, in which a woman believes she is pregnant, despite not having a real conception. This belief is associated with physical changes and subjective symptoms (such as nausea) that can simulate pregnancy.
Pseudociesis appears as the consequence of psychological and neuroendocrine mechanisms that mutually influence the balance between mind and body. The syndrome can appear when there is a very strong desire to have a child and this cannot be fulfilled. otherwise, that is, when you have an uncontrolled fear of being pregnant and you don't want it.
Women suffering from hysterical pregnancy almost always manage to get through this, but they need psychotherapeutic support. This approach seeks to investigate the underlying causes of the disorder with the aim of bringing the patient to live the desire for motherhood in a healthy and balanced way.
Synonyms
Hysterical pregnancy is also referred to as pseudociesis or false pregnancy.
Hysterical pregnancy: an ancient ailment
Hysterical pregnancy is not a recent phenomenon: for centuries, this condition has captured the interest of doctors and non-doctors.
The first references to the disorder were found in the writings of Hippocrates (300 BC); the problem is also reported by some medieval documents and was later dealt with by Freud. Many historians claim that Queen of England Mary Tudor (known as the Bloody Mary or "Bloody Mary") suffered from pseudociesis.
Epidemiology
There are no reliable statistics to help explain how women experience hysterical pregnancy. The phenomenon was observed, in fact, in all ethnic and socio-economic groups.
The condition appears to be more common in women aged 20 to 39, but has also been described in girls before menarche and in postmenopausal older women.
Although precise figures relating to the prevalence of pseudociesis are not available, it has been found that the phenomenon tends to occur in cultures that place an absolute value on pregnancy (and the role of mother) and for which fertility is a prerequisite for marriage. or for a stable relationship.
In a historical document dating from the 17th-18th century, it was pointed out that most of the patients had been married and about half of these had already completed a previous pregnancy.
Today, the incidence of hysterical pregnancy appears to be decreasing in developed countries. This may be related to the trend towards a reduction in family size and the awareness that a woman's primary role is no longer just to raise children.
The risk of incurring this syndrome remains, however, in cultures in which having a lineage is considered a very important element.
Note. Hysterical pregnancy is not a manifestation limited only to humans: the phenomenon has also been observed in other mammals, such as dogs and mice.
Causes
Pseudociesis is classified as a “somatoform disorder” in the Diagnostic and Statistical Manual of Mental Disorders, a reference publication written by the American Psychiatric Association.
The development of pseudociesis involves psychological and neuroendocrine mechanisms that mutually influence the balance between mind and body. Emotional stress, the search for a woman-mother identity and strong social pressure seem to be at the basis of this pathology. Therefore, hysterical pregnancy can appear when the woman expresses a very strong desire to have a baby or, on the contrary, is overwhelmed by the uncontrolled fear of being pregnant when she does not want it, for personal reasons and / or cultural considerations.
Scholars of the phenomenon argue that this psychological malaise can determine the involvement of the "hypothalamus-pituitary-ovary axis, altering its function. This would result in an" abnormal secretion of hormones (including estrogen and prolactin), capable of inducing, in the body of the woman, a series of physical changes similar to those found in the actual gestation period.
Furthermore, when a deep depressive state is present, it is possible that neurotransmitters (such as serotonin) and biogenic amines, involved in the regulation of reproductive hormones, are affected.
Risk factors
Factors that can promote hysterical pregnancy include:
- An exasperated desire to become a mother or, on the contrary, fear of conceiving children;
- Infertility or loss of reproductive capacity (following, for example, menopause, abortion or hysterectomy);
- Interpersonal pressures (trying to maintain a relationship, loneliness or difficult relationships with significant people in the family);
- Low self-esteem;
- Tendency to misunderstand somatic stimuli;
- Naivety about medical matters;
- Presence of some psychological problem or anxiety to the idea of pregnancy.
The cultural pressure of giving birth to a child of a specific sex can also affect the disorder. In susceptible women, pseudociesis has been found in the setting of liver failure, systemic lupus erythematosus, abdominal neoplasms, hyponatremia, and cholecystitis.
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