title: Delusions of pregnancy in older women: a case series.
abstract: BACKGROUND
  Delusions of pregnancy have been reported in a wide variety of functional and organic psychiatric conditions but rarely with dementia. Most such delusions arise in women of child-bearing age. We report five cases in older women all of whom had severe constipation that probably precipitated this delusion.
  
  
  METHODS
  Of the five women (age 74-89 years), two had dementia, two had delirium and one had both. All patients had borne healthy children. Three women reported that they were in labour, and one was concerned that the baby was not moving. All had severe constipation on examination or imaging, and three had faecal impaction. All were treated with laxatives or enemas, and only one patient required brief antipsychotic therapy. The delusions lasted from a few hours to 5 days. In general, resolution of the delusion occurred in concert with improvement in bowel function, although in one case a large bowel movement was followed by the delusion that a baby had been born.
  
  
  CONCLUSIONS
  These cases suggest that misinterpretation of abdominal symptoms due to severe constipation in cognitively impaired women may trigger the delusion of being pregnant and that treatment of constipation often leads to resolution of the delusion.
authors.affiliation: Geriatric Medicine, Merlin Park Regional Hospital, Unit 4 Merlin Park Hospital, Galway, Ireland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Guilfoyle
authors.affiliation: Geriatric Medicine, Merlin Park Regional Hospital, Unit 4 Merlin Park Hospital, Galway, Ireland.
authors.forename: Helen
authors.initials: H
authors.lastname: O'Brien
authors.affiliation: Geriatric Medicine, Merlin Park Regional Hospital, Unit 4 Merlin Park Hospital, Galway, Ireland.
authors.forename: Shaun T
authors.initials: ST
authors.lastname: O'Keeffe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000150:complications / Q000523:psychology; D003693:Delirium / Q000150:complications; D003702:Delusions / Q000209:etiology / Q000523:psychology*; D003704:Dementia / Q000150:complications; D005260:Female; D006801:Humans; D011247:Pregnancy / Q000523:psychology*
keywords: constipation; delirium; delusions of pregnancy; dementia; older people