Academic journal article Indian Journal of Psychiatry

Delusion of Pregnancy in a 70-Year-Old Male

Academic journal article Indian Journal of Psychiatry

Delusion of Pregnancy in a 70-Year-Old Male

Article excerpt

Byline: Bhagyashree. Gaikwad, Amit. Dharmadhikari, Alka. Subramanyam, Jahnavi. Kedare, Ravindra. Kamath

Sir,

“Delusion of pregnancy” according to the Diagnostic and Statistical Manual of Mental Disorders, 5[sup]th Edition (DSM-5), within the realms of schizophrenia spectrum and other psychotic disorders, is described as delusional disorder somatic type. The literature on the topic has included multiple case reports, but large-scale epidemiological descriptive or cohort studies are lacking. A review of forty articles by Bera and Sarkar included 84 cases that showed that about one-fourth of the patients had developed delusion of pregnancy after the age of 50 years, and it has been found to present in equal proportion in both genders.[sup][1] However, there is barely any literature available on delusion of pregnancy in geriatric age group.

We here report a case, Mr. A, 70-year-old male patient, referred from the Endocrinology Outpatient Department (OPD), with complaints of feeling guilty, having low mood and passive suicidal ideas. After a homosexual encounter with a friend, 4 months back, the patient started believing that he had become pregnant, and he stated that he was getting converted into a female, started noticing bodily changes such as enlargement of his breasts, trying to hide them by wearing loose clothes, would repeatedly check his body parts in mirror, reduced his food intake to avoid weight gain, for which he approached the Endocrinology OPD. On further enquiry, we found that the patient had been suspicious of his wife for having extramarital affair which was false as confirmed by their son and the wife herself, and owing to which, he had no sexual relationship with her for the last 8 years. He also suspected his daughter-in-law of infidelity toward his son.

On mental status examination, we found that he had sad mood, delusion of pregnancy, delusion of infidelity, ideas of hopelessness, helplessness, worthlessness, and passive suicidal ideations.

We admitted him in the inpatient psychiatric unit and conducted a battery of tests, which ruled out his gynecomastia and hormonal changes as age related, for which he had first approached the endocrinology services. A cognitive evaluation including serum Vitamin B12 level and serum homocysteine and Vitamin D3 levels was done, which was normal. …

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