CAN DENIAL OF PREGNANCY BE A DENIAL OF FERTILITY? A CASE DISCUSSION

Background: For many years, several cases of neonaticide resulting from a denial of pregnancy were reported in the press. Recently, a case of neonaticide made headlines in Belgium: a woman realised that she was pregnant during childbirth. A few minutes after the delivery, the baby was asphyxiated to death. In the obstetric history of the patient, we note six pregnancies, of which three births were given to anonymous adoption. Mrs D. was not able to explain why she was not using any method of contraception despite all of her pregnancies. Many questions need to be asked in order to further understand denial of pregnancy. Do these women understand the link between sexual intercourse and the potential of pregnancy? Which women are more at risk of denying their pregnancy? Is there a certain personality profile at risk? Methods: In the following article, we report the case of Mrs D. who presented to the consultation of the clinic of CHU Mont- Godinne (Belgium). We will also discuss the literature available on the online databases (PubMed, PsycArticles, PsycInfo and Cairn.info) using the following keywords: denial of pregnancy, neonaticide, contraception. Results: In the results of retrospective studies, we notice that indeed most women who have had a denial of pregnancy were not using any method of contraception. This observation suggests the hypothesis of a denial of fertility in these women. In addition, it appears that a specific personality profile is very difficult to establish, due to the lack of sufficient data and due to the discrepancy of the results concerning these women, especially in the matters of age and socio-economic status. However we can note that some psychological characteristics are similar. Conclusions: The denial of pregnancy is a complex mechanism, which still raises many questions in the clinical setting and in matters of etiopathogenesis. In these patients, we note that denial is a defense mechanism regularly used, even in other aspects of their lives. Moreover, the frequent non-use of contraceptive method might therefore be more in favor of a denial of fertility than of a denial of pregnancy

CAN DENIAL OF PREGNANCY BE A DENIAL OF FERTILITY? A CASE DISCUSSION

Background: For many years, several cases of neonaticide resulting from a denial of pregnancy were reported in the press. Recently, a case of neonaticide made headlines in Belgium: a woman realised that she was pregnant during childbirth. A few minutes after the delivery, the baby was asphyxiated to death. In the obstetric history of the patient, we note six pregnancies, of which three births were given to anonymous adoption. Mrs D. was not able to explain why she was not using any method of contraception despite all of her pregnancies. Many questions need to be asked in order to further understand denial of pregnancy. Do these women understand the link between sexual intercourse and the potential of pregnancy? Which women are more at risk of denying their pregnancy? Is there a certain personality profile at risk? Methods: In the following article, we report the case of Mrs D. who presented to the consultation of the clinic of CHU Mont- Godinne (Belgium). We will also discuss the literature available on the online databases (PubMed, PsycArticles, PsycInfo and Cairn.info) using the following keywords: denial of pregnancy, neonaticide, contraception. Results: In the results of retrospective studies, we notice that indeed most women who have had a denial of pregnancy were not using any method of contraception. This observation suggests the hypothesis of a denial of fertility in these women. In addition, it appears that a specific personality profile is very difficult to establish, due to the lack of sufficient data and due to the discrepancy of the results concerning these women, especially in the matters of age and socio-economic status. However we can note that some psychological characteristics are similar. Conclusions: The denial of pregnancy is a complex mechanism, which still raises many questions in the clinical setting and in matters of etiopathogenesis. In these patients, we note that denial is a defense mechanism regularly used, even in other aspects of their lives. Moreover, the frequent non-use of contraceptive method might therefore be more in favor of a denial of fertility than of a denial of pregnancy

HYPERSEXUALITY IN NEUROCOGNITIVE DISORDERS IN ELDERLY PEOPLE – A COMPREHENSIVE REVIEW OF THE LITERATURE AND CASE STUDY

Background: Hypersexuality is defined as an increase in libido. It is often confounded with sexual disinhibition and inappropriate sexual behavior directed against oneself or against others. It is described in 2.9 to 8% of patients living at home and in 3.8 to 7% of patients in institutions. The pathophysiology of hypersexuality is complex. Several brain areas are involved. The psychological factors are also important. We found it useful to present a clinical case of a patient who presented with symptoms of hypersexuality and to discuss the diagnosis and the management. Methods: Data collection was based on the case of a patient hospitalized in the Department of Psychosomatic medicine in CHU Mont-Godinne - Yvoir - Belgium in February 2013. For the literature review, we used the database PubMed with the following keywords: hypersexuality, dementia. A total of 40 articles were selected for this study. Results: The patient had symptoms of hypersexuality, and hyperorality in the context of delirium induced by benzodiazepine withdrawal. A blood test and brain imaging were normal. She was put under risperidone 2 mg with complete resolution of symptoms within a few days. Conclusion: The diagnosis of Kluver-Bucy syndrome in the context of a minor neurocognitive disorder was retained. Management is mainly non-pharmacological using behavioral techniques. The education of the patient, his partner and caregivers are essential. Pharmacotherapy is sometimes necessary. It is reserved as a last resort because of the serious side effects of the drugs used

Can denial of pregnancy be a denial of fertility? A case discussion.

The denial of pregnancy is a complex mechanism, which still raises many questions in the clinical setting and in matters of etiopathogenesis. In these patients, we note that denial is a defense mechanism regularly used, even in other aspects of their lives. Moreover, the frequent non-use of contraceptive method might therefore be more in favor of a denial of fertility than of a denial of pregnancy