Abstract
To the Editor
There has been an attempt to classify delusions related to various stages of procreation under a single rubric called ‘delusional procreation syndrome’ (Manjunatha et al., 2010). Most commonly reported among these phenomena is delusion of pregnancy (Chaturvedi, 1989; Manoj et al., 2004). There have been two reports of ‘delusion of maternity’, (Hrdlicka, 1998; Manjunatha et al., 2010), but only one previous report of ‘delusion of having spouse’ and ‘delusion of paternity’ (Manjunatha et al., 2010).
Mr A, a 45-year-old unmarried man was admitted to hospital with a two-year history of social withdrawal. He had a history suggestive of mild mental retardation and complex partial seizures that were well controlled with medications. He was very friendly with one of his female cousins. A few years ago, when she got married, he started asking his parents for marriage. When his cousin delivered a baby girl a year ago, he started claiming that he also has a daughter. Her name was ‘Priya’ (name changed for confidentiality) and he interacted with her every day. To his parents, he described her as a small child who stays with him in his room and that he planned to buy things for her and to send her to school. His parents saw him sitting and talking to himself and laughing many times in a day as if he was interacting with someone invisible. On questioning about how he can have a child without a wife, he would say that he had a wife called ‘Parvathy’ (name changed for confidentiality). However, he never described her any further. His life was preoccupied with these symptoms and experiences. He was diagnosed as having delusional disorder and was treated with risperidone 6 mg and trihexyphenidyl 4 mg, with which he showed significant improvement.
This patient had a delusion of paternity that he was father to a child. In addition, he possibly had a ‘delusion of having spouse’ but this was never well elaborated.
There are two ways of understanding this phenomenon. Firstly, from a psychodynamic perspective, the patient may have had a subconscious sexual wish to possess his cousin. Being unacceptable to the super ego, this wish was repressed by the ego. The cousin got married and had a child. The belief of having a child unconsciously implied a wish fulfilment of sexual union with his cousin. An alternative explanation can be formulated using Erikson’s theory of stages of psychosocial development (Erikson, 1968). The patient was in his early 40s when his cousin got married, which is the stage of intimacy versus isolation. The marriage of the cousin may have evoked a desire for intimacy which correlated with his requesting his parents to get him married. The next stage of development is of generativity versus stagnation. This correlated with the onset of his ‘delusion of paternity’ that he had a daughter, when he was 44-years-old. The belief gave him the chance to fulfil his desire for generativity. This report adds to the very limited literature regarding this concept.