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Psychiatry · Anxiety and related disorders: pseudocyesis
Sample itemA 40-year-old woman desperate for a child has amenorrhoea, abdominal distension, breast enlargement and morning nausea, and firmly believes she is pregnant. Urine hCG is negative and ultrasound shows an empty uterus. What is the most likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Pseudocyesis
Pseudocyesis, or false pregnancy, is a somatic symptom presentation with a firm belief in being pregnant and real physical signs such as amenorrhoea, abdominal enlargement and breast changes, but without a fetus. It is linked to intense desire for or fear of pregnancy.
Option by option
A. Factitious disorder
Factitious disorder involves deliberately feigned illness, not a sincere belief with genuine bodily changes.
B. Couvade syndrome
Couvade syndrome affects the partner of a pregnant woman, who develops pregnancy-like symptoms.
C. Delusional parasitosis
Delusional parasitosis is a fixed belief in infestation by organisms, which does not apply here.
D. Pseudocyesis (correct)
Correct. A firm belief in pregnancy with objective signs but no fetus is pseudocyesis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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