Nous rapportons dans cette observation le cas d’une femme de 49ans, qui présente pour la septième fois une grossesse délirante, accompagnée d’un syndrome polydipsique.

Son délire s’est accompagné des symptômes habituels de la grossesse, notamment des nausées et des vomissements, une augmentation importante du volume abdominal, une tension mammaire et une aménorrhée. Le bilan gynécologique, radiologique et hormonal a conclu à une stérilité primaire, une ménopause confirmée et une absence de grossesse. L’examen psychiatrique a montré un syndrome dépressif avec un délire systématisé, axé autour de deux thèmes : la grossesse et la possession démoniaque.

Nous présentons dans ce travail une discussion diagnostique et une revue de littérature. Dans notre cas, les données étaient similaires à celles qui y étaient rapportées.

Pseudocyesis is an imaginary pregnancy resulting from a strong desire or need for motherhood. Pseudocyesis has become increasingly rare in many parts of the world in which accurate pregnancy tests have become widely available. Cultures that place high value on pregnancy, or that make close associations between fertility and a person’s worth, still have high rates of the disorder. A woman may believe in her pregnancy to the point of delusion and show acute depression when no baby is born.

This report describes a case of recurrent pseudocyesis and polydipsia in a 49-year-old woman. She was an illiterate housewife who had been married since she was 21years old. Four years later, she divorced because of a problem of sterility. She got remarried, five years later, and the couple had no child.

The patient was admitted into the Obstetric Unit thinking that she was about to give birth. She presented all the symptoms of true pregnancy. She had abdominal distension, amenorrhea, mammary tension, nausea and vomiting, and weight gain. She claimed to have felt foetal movements. Other than this, she exhibited a polydipsia syndrome. These symptoms had evolved over 20months. The patient had previously presented six similar episodes. All these episodes were identical. The length of these episodes varied between three and five months, after which all the signs disappeared progressively.

The patient had never consulted for these symptoms before the present episode. During her stay in the Obstetric Unit, she benefited from a complete gynaecological examination, including pelvic ultrasound examinations, and laboratory tests, notably hormone assays (FSH, LH, prolactin, ß-HCG) and serum electrolyte levels. A primary sterility and menopause were confirmed.

Otherwise, the psychiatric assessment confirmed the delusion of pregnancy and the presence of a depressive syndrome. The patient reported that she was possessed. She explained the normality of the imagery and laboratory tests by the intervention of the demons that hid the fœtus and modified the results.

The contribution of psychological and physiological factors in the development of the delusion of pregnancy, possession and polydipsia, and the possible interactions between the two phenomena are discussed.