THE PSYCHOSOMATIC IMPLICATIONS OF PSEUDOCYESIS1,2

Abstract

The literature on the clinical syndrome of pseudocyesis is discussed to show the variety of physical and endocrine changes that may be present. This is compared with the similar picture of false-pregnancy in dogs, and the experimental work on lower animals is reviewed in an attempt to elucidate the endocrine mechanism involved. False-pregnancy in rats and mice may be induced by infertile coitus, mechanical or electrical stimulation of the cervix, electrical stimulation of the head, and depressants applied to the nasal mucosa. A corpus luteum persists during the period of falsepregnancy. Ovulation and false-pregnancy follow coitus in the rabbit, the mechanism apparently being that sexual excitement, but not specific genital stimulation, acts on the pituitary through the autonomic nervous system with resulting endocrine effect on the ovary causing a persistent corpus luteum. Clinical evidence is given for the presence of persistent corpus lutea in some cases of human pseudocyesis. The possibility of a previous undiagnosed abortion as a precipitating factor is discussed. Psychogenic influences on the pituitary are illustrated by two cases of psychogenic lactation, where low estrogen activity was apparently a factor. Five cases of pseudocyesis were gathered from the hospital records, portraying the difficulties in diagnosis and the problem of excluding previous abortion. A study was made of a seventeen-year-old girl with pseudocyesis; the psychological picture was one of conversion hysteria with a strong oedipus attachment and a great desire to rival the mother by having a baby. Urinary hormone assays, vaginal and oral smears showed a suppression of ovarian activity, and there was one high gonadotropic assay. The literature suggests that there might be a correlation between this patient's naivete concerning the changes expected in pregnancy and the lack of any overt endocrine disturbances except amenorrhea.