Pseudocyesis, a false belief of being pregnant that is associated with objective signs of pregnancy, is seldom a subject of professional debate because of its infrequency.

In the case presented, pseudocyesis was preceded by six unsuccessful IVF procedures and followed by delusions of maternity.

A 39-year-old woman, an immigrant from the Muslim part of Bosnia, was admitted to our clinic after the sixth IVF procedure. Upon admission she had a plastic doll with her. She claimed to have delivered a baby, but she could not remember the delivery itself. After the delivery her belly became flat. She was breast-feeding her imaginary daughter and she was carrying her around all the time. Despite antipsychotic and antidepressant therapy, her condition was worsening. She had auditory hallucinations and she became more and more depressed and suicidal. After seven months soon after a higher dosage of risperidone was given, her condition improved. She confided to the medical staff that her daughter had died and that she had buried her. Nurses found the plastic doll on the earth pile. After the discharge she continued her treatment as an outpatient.

Pseudocyesis has become increasingly rare in many parts of the world where accurate pregnancy tests have become widely available. However, cultures that place high value on pregnancy or that make close associations between fertility and a person's worth, still have high rates of the disorder. The case presented is the first published case of pseudocyesis that was followed by delusions of maternity.