The Reality Check Episode 65

False Pregnancy + Scott Gavura + Cancer Support Groups

Part 1:
False pregnancy or hysterical pregnancy, most commonly termed pseudocyesis in humans and pseudopregnancy in other mammals, is the appearance of clinical and/or subclinical signs and symptoms associated with pregnancy when the person or animal is not pregnant. Clinically, false pregnancy is most common in veterinary medicine. False pregnancy in humans is less common, and may sometimes be purely psychological. It is generally estimated that false pregnancy is caused due to changes in the endocrine system of the body, leading to the secretion of hormones which translate into physical changes similar to those during pregnancy. The underlying cause is often mental.- Wiki

One spring day last year, a young woman walked into the clinic of the Boston Lying-in Hospital. She had the "profile," said Dr. Robert Northwall Rutherford, of a woman five months' pregnant. Proudly she told the doctor about the lively kickings of her unborn child, which her husband had also noticed.
Dr. Rutherford gave the patient a careful examination. She was not pregnant. She had no tumor. He wanted to find out what caused the huge swelling, but "she received the diagnosis of spurious pregnancy with contempt," and marched off to consult another physician.
That and similar cases set Dr. Rutherford to scrabbling around in old records, trying to find out something about "pseudocyesis," or false pregnancy. Last week he reported his findings in the New England Journal of Medicine. Excerpts :
> The condition is by no means rare: hundreds of cases have been reported in medical literature. Most famous case: Mary Tudor, Queen of England. In addition to a distended abdomen, a woman may present other signs of pregnancy such as amenorrhea (absence or suppression of menstruation), full breasts, fetal movements, etc. If a doctor is at all suspicious, a biological test, like the Aschheim-Zondek pregnancy test, will solve the problem. But a few doctors have been taken in by the symptoms.
> Most of the women with spurious pregnancy are in their early 30s, are childless, and eager for offspring. They may go from doctor to doctor hoping for encouragement, even prepare baby clothes. Some of them have later gone through a normal pregnancy; in some cases they started in the midst of a spurious pregnancy.
> Many conditions may cause symptoms of pseudocyesis. Sometimes, in older women, an apron of fat develops over the abdomen at menopause. Other women may have large tumors, or their abdomens may be distended with air. Most common cause is hysteria: an intense psychological desire for a child creates a muscular spasm which pushes the abdomen out. Treatment varies : purges may be helpful, or the muscles may be worked into place while the patient is under an anesthetic. Since most of the cases are hysterical, Dr. Rutherford thinks pseudocyesis is psychiatry's baby. - Time

Part 2:
Interview with Scott Gavura!
Listen to the Interview here: The Reality Check Episode 65

Science Myth of the Week:
Two widely publicised studies have contributed to the myth that the biological progress of cancer can be effectively battled with the power of the mind. Unfortunately these studies - one at Stanford and one at UCLA - have been heavily criticised and subsequent research has failed to back them up.

The headline result of the Stanford study, published in 1989 seemed impressive. Women with metastatic breast cancer who took part in a support programme lived twice as long as the control group ). Both groups were, of course, also receiving normal medical care for cancer.
Later examination of the results, though, revealed telling problems, which Barry Beyerstein and colleagues point out (Beyerstein et al., 2007). The major question-mark was over the control group, who were much more short-lived than would normally be expected. It turned out that the group who had taken part in the support programme had survived for about the average time: it was the control group who had made the treatment look effective.
The UCLA study, published in 1996, also appeared to have impressive results. They found that in melanoma patients, 92% of those given a social support intervention were still alive after 5 years, compared to only 72% of those who weren't (Fawzy et al., 1993).
Closer inspection, though, revealed that this study might have been afflicted by the same problem as the Stanford study. It was the control group whose five-year survival rate was poorer than normal. The survival rate of those given the social support intervention was about average.- PSYBLOG