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When reading Yadav (2012) I was intrigued by the fact that the patient had recently been through a truly traumatic life changing experience in the bereavement of her son. The stress and depression that inevitably would have resulted from the loss of her son may have provoked her body into producing a chemical imbalance, with the derivation of amino acids to monoamine neurotransmitters and neuromodulators within the brain throwing the levels of dopamine, serotonin and norepinephrine out of sync. This would inevitably affect the body’s pituitary gland, which is responsible for many important functions of the body including: growth, blood pressure, pregnancy (in women), childbirth (in women), uterine contractions (in women) breast milk production (in women), sex organ function (in both sexes), thyroid gland function, sleeping patterns, pain relief, temperature regulation, water levels within the body and the body’s metabolic rate.
This affecting of the pituitary gland by a chemical imbalance within the body can easily been seen as a possible reason for what are reported as the most common physical symptoms of a false pregnancy as set out in a case report by Marusic (2006) of: amenorrhea (cessation of the menstrual cycle), tender and swollen breasts, distended abdomen, morning sickness and even foetal movement. Indeed the definition of pseudocyesis set out in the Columbia Electronic Encyclopaedia (2003) goes as far as to state that pseudocyesis is when a ‘psychological desire or depression triggers the pituitary gland to secrete elevated hormones, mimicking the hormones changes of real pregnancy’. Keller’s (2013) news article also discusses the role of the pituitary gland in determining a pseudocyesis as being a pivotal one, while Tarin (2013) suggests that the reason that pseudocyesis rates appear to be higher amongst women who have a dual diagnosis of mental illness – something shown with the work of both Caixeta (2013) in Brazil and Moselhy (2000) in the United Kingdom – is because of the role antipsychotic and antidepressant medications can play in inhibiting dopamine secretion, raising prolactin levels, inducing amenorrhea, causing swelling and tenderness in the breast, and initiating galactorrhea (milky discharge from the breast), all of which are controlled by the pituitary gland. Indeed Caixeta reported that ninety per cent of the case study patients in Brazil had an underlying affective and/or psychotic disorder and with Moselhy the figure stood at one hundred per cent as he was reporting on three case studies from Bushey Fields Hospital which is a mental health facility in the United Kingdom. A further case study from the United Kingdom was presented by Ahuja (2008) who saw pseudocyesis induced in a patient by the hyperprolactinemia brought about by the taking of antipsychotic medication at the Hunter Memorial Hospital in Wallsend, Northumberland. This clearly indicates that there may be some form of correlation between pseudocyesis and the side-effects of psychiatric medications, which would warrant further investigation. In terms of being able to visually see the probable and possible effects of antipsychotic, antidepressant and mood stabilizing medications on the neurotransmitters and neuromodulators within the brain Stahl (2009, 2009, 2009.) sets out very clear and detailed images and explanations within his medical textbook guides to these medications.
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