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In concluding the literature review I broke down the academic theories into four main camps; the psychiatric chemical imbalance theory, the dual-diagnoses theory, the physical misdiagnosis theory and the psychological desire theory. In pursuing these six interviews support can be found for each of these four theories.
The psychiatric chemical imbalance theory finds strong support in the recounting of the lived experience of the nurse presenting Patient 3. In this account we are informed that the pseudocyesis appears to have developed as a direct response to a change in the patient’s medication and the same pseudocyesis reportedly ceased when this same medication was itself changed. Support is also strengthened for this theory with the case study of Patient 6 where the nurse concludes the interview by theorises that they believe that a psychiatric chemical imbalance may have been the root cause of the pseudocyesis in their patient. Patient 1 also lends support to this theory in that her lack of physical symptoms mean she may easily have been suffering with a side-effect of her anti-psychotic medication and then through her delusional tendencies have formed the belief that she was pregnant when in fact all clinical testing indicated otherwise.
The dual-diagnosis theory is supported by the case studies of Patient 2 (amenorrhea, breast lactation, breast swelling, distended abdomen and positive pregnancy test) and Patient 4 (breast swelling, distended abdomen, fatigue and temperature). Both of these case studies prove to be unresolved in their causation factors and therefore support this theory by default as the two patients have clearly suffered a form of physical illness give their prolonged list of symptoms and that the co-morbid nature of their mental illness at the time may have provoked an unsubstantiated belief within themselves that they were pregnant. These two patients can be held in contrast to Patient 1, who whilst having been reported as having a distended abdomen lacked any further physical symptoms or complications – whilst it is easier to explain the possible causation of a single physical symptom it is harder to accurately explain the causation of several physical symptoms in these patients.
The physical misdiagnosis theory finds great support with the case study of Patient 5 who was eventually diagnosed as suffering from irritable bowel syndrome. The patient had a collection of presenting physical symptoms, some of which may have been due to her other pre-existing physical ailments and conditions which complicated the initial diagnosis. Also the importance of the pregnancy test that the patient did and that was returned with a positive reading can be underplayed as it is what led to the patient believing in the idea that she was pregnant, as up until that point she had clearly not had that thought in mind. The result of this ‘dud-test’ caused confusion and prolonged the time it took the clinician’s to diagnose the patient’s condition, this time and confusion contributed in a major way to the patient being able to draw the false conclusion that she was pregnant.
The psychological desire theory then finds support in perhaps all the case studies but particularly those of Patient’s 2 and 4 whom it would appear had a deeply held psychological desire to become pregnant. Patient 2 is presented as being a lady who had not fully come to terms with the fact that many years before her child had been taken from her and relocated to an adoptive family. She appears to have been in a state of grief ever since the event happened and perhaps her mental illness was something that hindered her in her ability to rationalise and process the extreme feelings and emotions that anyone would have felt in her position. This psychological undertone of bereavement from her long lost son then perhaps manifested itself in the pseudocyesis that then presented. Likewise, with Patient 4 who was reported to have been lonely and socially isolated it can be theorised that a significant new intimate relationship proved the causation to a pseudocyesis in an a subconscious attempt to make a new family for herself. However, it must be stated that this is merely one way of interpreting these case studies and does not necessary represent the truth of what happened in these instances.
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