Delusional Ideas of Pregnancy, Hyperprolactinemia and/or Culture?

Delusional ideas of pregnancy are defined by one’s conviction of being pregnant despite factual evidence of the contrary as shown by negative paraclinical test results. Different etiologies of this symptom have been documented and hyperprolactinemia is amongst them. We report the case of a Tunisian 39-year-old, bipolar type I woman, with a personal history of primary infertility and hyperprolactinemia associated with a hypophyseal adenoma that subsided with Carbagoline. Shortly after the discontinuation of this specific treatment, she was admitted in our psychiatric department following an episode of agitation, insomnia and irrelevant talk. Psychiatric evaluation revealed a severe manic syndrome associated with delusional ideas of being pregnant with cats. Her laboratory results confirmed the absence of pregnancy and found elevated serum levels of Prolactin. The patient was treated with Aripiprazole. Her serum levels of prolactin returned within normal range. Significant improvement of her manic symptoms and delusional ideas was noted. Hyperprolactinemia should be taken into consideration when confronted with a delusional pregnancy. In Tunisia, cats are often associated with pregnancy and maternity. Symbols and cultural aspects related to pregnancy differ from one region of the world to another and may impact the content of these delusional ideas.