The clinical correlates of couvade syndrome: a case report in a patient with functional tics

Couvade syndrome (“sympathetic pregnancy”) is a neuropsychiatric condition characterized by the development of both somatic and psychological/emotional symptoms similar to those of an expectant partner or – less commonly – another closely connected person. We document the case of a 55-year-old man with a diagnosis of functional neurological disorder (clinical presentation: functional tics) and a history of couvade syndrome dating back to when he was 15. Significantly, there was a longstanding history of underlying anxiety with dissociative features bridging the two main clinical manifestations. In predisposed individuals, witnessing the experience of pregnancy in a closely connected person may act as a potent psychosocial trigger, facilitating the conversion of psychological distress into somatic or functional neurological symptoms. The spectrum of co-morbid disorders can provide important clues to better characterize the pathophysiological processes underlying couvade syndrome. Our case report on the potential association between couvade syndrome and functional tics/functional neurological disorder allows hypothesizing the underlying role of long-term shared biopsychosocial etiological mechanisms.