Part 1:
![Psych Evaluation: Couvade Syndrome [1/4] by Transviscera](https://images-wixmp-ed30a86b8c4ca887773594c2.wixmp.com/f/87684d17-8b34-4054-a6cc-9b9e97dcb44a/dft3z55-e8034db5-ea0e-4ca8-9d73-040ab9207cad.png/v1/fit/w_150,h_150,q_70,strp/psych_evaluation__couvade_syndrome__1_4__by_transviscera_dft3z55-150.jpg?token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJzdWIiOiJ1cm46YXBwOjdlMGQxODg5ODIyNjQzNzNhNWYwZDQxNWVhMGQyNmUwIiwiaXNzIjoidXJuOmFwcDo3ZTBkMTg4OTgyMjY0MzczYTVmMGQ0MTVlYTBkMjZlMCIsIm9iaiI6W1t7ImhlaWdodCI6Ijw9MjA0OCIsInBhdGgiOiJcL2ZcLzg3Njg0ZDE3LThiMzQtNDA1NC1hNmNjLTliOWU5N2RjYjQ0YVwvZGZ0M3o1NS1lODAzNGRiNS1lYTBlLTRjYTgtOWQ3My0wNDBhYjkyMDdjYWQucG5nIiwid2lkdGgiOiI8PTI3NzkifV1dLCJhdWQiOlsidXJuOnNlcnZpY2U6aW1hZ2Uub3BlcmF0aW9ucyJdfQ.eey5NM-DMxohvMLHs8XlIGfajl3WEvD-yLjREUvDLYg)
Part 2:
![Psych Evaluation: Couvade Syndrome [2/4] by Transviscera](https://images-wixmp-ed30a86b8c4ca887773594c2.wixmp.com/f/87684d17-8b34-4054-a6cc-9b9e97dcb44a/dft41m3-e85abf43-effd-419c-9c63-8e0e92e8b6b3.png/v1/fit/w_150,h_150,q_70,strp/psych_evaluation__couvade_syndrome__2_4__by_transviscera_dft41m3-150.jpg?token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJzdWIiOiJ1cm46YXBwOjdlMGQxODg5ODIyNjQzNzNhNWYwZDQxNWVhMGQyNmUwIiwiaXNzIjoidXJuOmFwcDo3ZTBkMTg4OTgyMjY0MzczYTVmMGQ0MTVlYTBkMjZlMCIsIm9iaiI6W1t7ImhlaWdodCI6Ijw9MTA4NCIsInBhdGgiOiJcL2ZcLzg3Njg0ZDE3LThiMzQtNDA1NC1hNmNjLTliOWU5N2RjYjQ0YVwvZGZ0NDFtMy1lODVhYmY0My1lZmZkLTQxOWMtOWM2My04ZTBlOTJlOGI2YjMucG5nIiwid2lkdGgiOiI8PTIxMDgifV1dLCJhdWQiOlsidXJuOnNlcnZpY2U6aW1hZ2Uub3BlcmF0aW9ucyJdfQ.G8RcjWeNdKk5bOAK4zeGa6lv_CoUYMJ-YKq2LYfac1k)
Part 3:
![Psych Evaluation: Couvade Syndrome [3/4] by Transviscera](https://images-wixmp-ed30a86b8c4ca887773594c2.wixmp.com/f/87684d17-8b34-4054-a6cc-9b9e97dcb44a/dft495h-fa85190a-75f2-4a31-bffb-93540c1c405a.png/v1/fit/w_150,h_150,q_70,strp/psych_evaluation__couvade_syndrome__3_4__by_transviscera_dft495h-150.jpg?token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJzdWIiOiJ1cm46YXBwOjdlMGQxODg5ODIyNjQzNzNhNWYwZDQxNWVhMGQyNmUwIiwiaXNzIjoidXJuOmFwcDo3ZTBkMTg4OTgyMjY0MzczYTVmMGQ0MTVlYTBkMjZlMCIsIm9iaiI6W1t7ImhlaWdodCI6Ijw9MTA4NCIsInBhdGgiOiJcL2ZcLzg3Njg0ZDE3LThiMzQtNDA1NC1hNmNjLTliOWU5N2RjYjQ0YVwvZGZ0NDk1aC1mYTg1MTkwYS03NWYyLTRhMzEtYmZmYi05MzU0MGMxYzQwNWEucG5nIiwid2lkdGgiOiI8PTIxMDgifV1dLCJhdWQiOlsidXJuOnNlcnZpY2U6aW1hZ2Uub3BlcmF0aW9ucyJdfQ.gAZHQpTrLagUNQoTcZsGDATyXyB4bY1f-DxcM8t_TS4)
Part 4:
![[DARK] Psych Evaluation: Couvade Syndrome [4/4] by Transviscera](https://images-wixmp-ed30a86b8c4ca887773594c2.wixmp.com/f/87684d17-8b34-4054-a6cc-9b9e97dcb44a/dft4b8z-7613b3ab-7037-44e0-8251-cdc724fd64e8.png/v1/fit/w_150,h_150,q_70,strp/_dark__psych_evaluation__couvade_syndrome__4_4__by_transviscera_dft4b8z-150.jpg?token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJzdWIiOiJ1cm46YXBwOjdlMGQxODg5ODIyNjQzNzNhNWYwZDQxNWVhMGQyNmUwIiwiaXNzIjoidXJuOmFwcDo3ZTBkMTg4OTgyMjY0MzczYTVmMGQ0MTVlYTBkMjZlMCIsIm9iaiI6W1t7ImhlaWdodCI6Ijw9MTA4NCIsInBhdGgiOiJcL2ZcLzg3Njg0ZDE3LThiMzQtNDA1NC1hNmNjLTliOWU5N2RjYjQ0YVwvZGZ0NGI4ei03NjEzYjNhYi03MDM3LTQ0ZTAtODI1MS1jZGM3MjRmZDY0ZTgucG5nIiwid2lkdGgiOiI8PTIzNzEifV1dLCJhdWQiOlsidXJuOnNlcnZpY2U6aW1hZ2Uub3BlcmF0aW9ucyJdfQ.VeIkMdDJHJ2Itpr2wdQ5oZE4C0gHWFDZ87GplaPg8KU)
Part 5:
Clinician: Doctor Muhammad Akram
Patient: Dumas, Thomas
Diagnosis: Couvade Syndrome, ?False Pregnancy, hormonal imbalance
Patient attended the ward along with his wife. Thomas displayed a distended abdomen and lumbar lordosis. I noted his wife was in the second trimester of pregnancy. There was evidently some minor intermarital tension regarding the patient's symptoms. Thomas appeared at times composed, at other times in tears, with mood fluctuating quickly without apparent cause.
Thomas reports that, since his wife's pregnancy, he has experienced difficulty with emotional regulation, becoming weepy over the slightest thing, to which his wife agrees. He is experiencing sickness and vomiting most mornings, and fatigue. As well as the swelling of his abdomen, he reported, with some embarrassment, sensitised nipples.
An examination confirmed they were indeed very pink, engorged and tender to the touch, with a chest that appeared puffy. Thomas was guarded against any attempt to examine or touch his abdomen, so I did not press the matter.
A blood screen indicated elevated levels of estradiol and prolactin.
I explained to the couple that I believe Thomas to be displaying Couvade syndrome, or sympathetic pregnancy, where he is subconsciously mirroring the pregnancy of his wife, even to the point of psychosomatically manifesting morning sickness and derangements in hormone levels. I gave them my best assurances that this was merely the sign of a close, empathic marital bond, prescribed a mild testosterone gel to assist with the symptoms, and discharged him.
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Mr Dumas returned one month after discharge. At first glance, it was clear had symptoms have worsened. His 'pregnant' belly had evidently grown, and was now even larger than his wife's, as well as progression of maternal-like physiological changes, including breast tissue, with a pair of small but noticeable breasts of remarkable tenderness. His blood screen is highly irregular, except for in that of a pregnant woman. Estradiol is elevated, prolactin is off the charts, and his testosterone is suppressed.
He reported a great deal of brain fog making it hard for him to think clearly. Given the hormonal soup that is his blood, this is not at all unsurprising.
When I enquired why Thomas hadn't been utilising the prescribed testosterone gel as instructed, he appeared confused, cradling his belly. "I was worried it might affect the baby," he said.
Fascinating. I've known Couvade syndrome and false pregnancy, but never a false pregnancy in a man. This may be a first! His exhausted wife, overwhelmed with her own, real pregnancy, has transferred him into my care for a few days for her own respite, during which time I hope to document his case for submission to a medical journal.