Antipsychotic-Induced Hyperprolactinemia and Delusion of Pregnancy

Northumberland, Tyne and Wear NHS Trust, UK.
Psychosomatics (Impact Factor: 1.86). 03/2008; 49(2):163-7. DOI: 10.1176/appi.psy.49.2.163
Source: PubMed


The authors describe 12 patients with antipsychotic-induced hyperprolactinemia. Six patients had erroneous ideas of being pregnant (four delusional and two non-delusional) temporally associated with hyperprolactinemia and resolving as prolactin levels returned to normal. The remaining six patients did not develop such ideas. Contrasting the clinical features of the two groups of patients in the context of existing literature informs on the possible biological and cognitive mechanisms that can be hypothesized to underlie the relationship between hyperprolactinemia due to antipsychotics and the development of inaccurate beliefs and feelings about pregnancy, and the effect of current mental state on the propensity to develop these beliefs.

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    • "It is difficult to distinguish between pseudocyesis and the delusion of pregnancy [3]. The delusion of pregnancy, a psychotic symptom that has been described in various psychiatric disorders and medical conditions, including antipsychotic-induced hyperprolactinemia (e.g., amenorrhea and galactorrhea) [4], antipsychotic-induced metabolic syndrome [5], polydipsia [6] and UTI [7], classically presents with a false, fixed and unshakable belief of pregnancy and an absence of physical signs. Nevertheless, our patient developed false belief of pregnancy after the subjective signs of abdominal enlargement and pain developed; and the false belief disappeared soon after the physical condition improved . "
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    ABSTRACT: Pseudocyesis is a rare condition wherein a nonpregnant woman shows signs and symptoms of pregnancy, such as abdominal enlargement, breast enlargement, pigmentation, cessation of menses, subjective sensation of fetal movement and labor pains at the expected delivery date. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, it is classified as a somatoform disorder, characterized by a false belief of being pregnant that is associated with objective signs of pregnancy. We report the case of a middle-aged female schizophrenic patient who developed pseudocyesis secondary to a urinary tract infection complicated by acute urine retention. The patient accepted that she had pseudocyesis after the causative medical condition resolved.
    General hospital psychiatry 07/2011; 34(1):101.e9-101.e10. DOI:10.1016/j.genhosppsych.2011.06.008 · 2.61 Impact Factor
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    • "The cases of delusion of pregnancy secondary to antipsychotic-induced lactation and amenorrhoea is also reported in a young girl (Cramer, 1971) and associated with antipsychotic-induced metabolic syndrome in divorced, post-menopausal mother of a child (Manjunatha and Saddichha, 2008). The temporal correlation of development and resolution of delusion of pregnancy with antipsychotic-induced hyperprolactinemia (Ahuja et al., 2008a, 2008b) and rechallenge with same antipsychotics and stopping also correlated with appearance and disappearance of delusion of pregnancy with hyperprolactinemia (Ali et al., 2003) lead to linking of prolactin as biological basis in delusion of pregnancy. Qureshi et al. (2001) implicated organic, coenaestho-pathological (disordered experience of exaggerated or distorted proprioceptive, kinaesthetic or haptic sensations of which the subject is not normally aware), socio-cultural, and religious factors in the etiology of delusion of pregnancy. "
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    ABSTRACT: The content of delusions in delusional syndrome has fascinated psychiatrists from antiquity. Delusions are classified on different principles such as, degree of inexplicability, subverted mental function, degree of independent nosological status, and on thematic content (traditional and logical). Delusions in sequence of procreation in three cases of schizophrenia along related delusions in published literatures are described under the broad rubric of term "delusional procreational syndrome" (DPS) (in the model of delusional misidentification syndrome), based on "logical thematic content" in the sequential phases of procreation. The DPS consists of numbers of delusions such as 'delusion of having spouse', 'delusion of pregnancy', 'delusion of delivery (child birth and labour)', 'delusion of being parents (paternity/maternity)' and so on. Authors also reviewed published literatures on these delusions. Though the concept of DPS is fascinating, further studies are needed to validate the concept of DPS.
    Asian Journal of Psychiatry 06/2010; 3(2):84-6. DOI:10.1016/j.ajp.2010.02.001

  • Revista de neurologia 11/2008; 47(9):502-4. · 0.83 Impact Factor
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