Investigation of Polyuria in Schizophrenia

Sleeper, Francis H.

doi:10.1176/ajp.91.5.1019

Cited by 40 publications

(14 citation statements)

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“…Most studies did not measure actual fluid intake; obtaining measurements can be very diffi cult because of patient noncompliance (Lawson et al 1992) . Polyuria has been used as an index of polydipsia even in the earlier studies (Sleeper 1935). Lawson and co workers (1985) used 2.5 liters as the threshold for poly uria.…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Neuroendocrine Factors Influencing Polydipsia in Psychiatric Patients: An Hypothesis

Verghese

León

Simpson

1993

Neuropsychopharmacol

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Polydipsia and water intoxication cause considerable morbidity and mortality in chronic psychiatric patients. Polydipsia in psychiatric patients has been described si nce the 1930s prior to the use of neuroleptics, but sys te matic study of the disorder has been done mostly in th e last two decades. There are many names for the dis order, which include psychogenic polydipsia (Bauer 1925), compulsive water drinking (Barlow and De Wardener 1959), psychosis, intermittent hyponatremia and polydipsia (PIP) syndrome (Vieweg et al. 1985) and self-induced water intoxication (Hobson and English 1963). The main purpose of this paper is to propose an hypothesis about the pathophysiology of the disorder and to reconceptualize some of the thinking about it.

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Section: Diagnostic Criteriamentioning

confidence: 99%

Neuroendocrine Factors Influencing Polydipsia in Psychiatric Patients: An Hypothesis

Verghese

León

Simpson

1993

Neuropsychopharmacol

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Section: Discussionmentioning

confidence: 99%

“…Potential medication effects also deserve comment, because all of our patients were treated with antipsychotics in the schizophrenia group and antidepressants in the depressed group, and this constitutes a major limitation in our study. Water regulation abnormalities in schizophrenia have been documented before the availability of antipsychotics (Hoskins, 1933;Sleeper, 1935) and are also observed in antipsychotic-free patients (Hariprasad et al 1980). In 1933, before the discovery of antipsychotics, Hoskins intensively studied 54 schizophrenic patients and found that that the average 24 h urine volume (obtained by catheter from all subjects) in the patients (2602 ± 120 ml) was twice the normal amount in healthy subjects (1328 ± 83 ml).…”

Section: Discussionmentioning

confidence: 99%

A translational approach for NMDA receptor profiling as a vulnerability biomarker for depression and schizophrenia

Gunduz‐Bruce

Kenney

Changlani

et al. 2017

Experimental Physiology

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New Findings r What is the central question of this study?Can the change in plasma arginine vasopressin concentration (P [AVP] ) in response to osmotic stimulation (P Osm ) serve as a biomarker for NMDA receptor signalling in schizophrenia and depression and thereby distinguish between these mental illnesses? r What is the main finding and its importance?In response to hyperosmotic challenge, depressed subjects showed increased P [AVP] response compared with healthy control and schizophrenic subjects. However, schizophrenic subjects were not different from healthy control subjects in this small sample. The 'P [AVP] response to P Osm ' is a suitable biomarker to distinguish depressed versus schizophrenic patients when used with psychiatric screening. This is the first objective physiological measure for schizophrenia or depression.Altered NMDA receptor activity and glutamate signalling might underlie the pathogenesis of both schizophrenia and depression in subgroups of patients. In schizophrenia, pharmacological modelling, post-mortem and imaging data suggest reduced NMDA signalling. In contrast, recent clinical trials demonstrating the efficacy of the NMDA antagonist ketamine in severely depressed patients suggest increased NMDA receptor signalling. We conducted a proof-of-concept study to assess whether there is any in vivo evidence for an inverse association in depression and schizophrenia with respect to the NMDA receptor function. For this purpose, we used a translational approach, based on findings from animal studies that NMDA receptor is a key mediator of arginine vasopressin (AVP) release into the bloodstream. Using hypertonic saline to increase plasma osmolality (P Osm ) and thereby induce AVP release, as done in animal studies, we found that in depressed patients the NMDA receptor-mediated AVP release induced by hypertonic saline infusion was significantly increased [0.24 (0.15) pg ml H. Gunduz-Bruce and others in depression and schizophrenia in subgroups of patients and provide the first in vivo evidence of this dichotomy.

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“…The literature offers conflicting data about the role that antipsychotic drugs play in water dysregulation. Reports of pervasive water dysregulation in chronic psychosis antedate the antipsychotic drug era (Hoskins, 1933;Hoskins & Sleeper, 1933;Sleeper, 1935;Sleeper & Jellinek, 1936). Sandifer (1983) reviewed antipsychotic drugs and hyponatraemia.…”

Section: Discussionmentioning

confidence: 99%

Abnormal diurnal weight gain among chronically psychotic patients contrasted with acutely psychotic patients and normals

et al. 1989

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SynopsisWe found diurnal weight gain to be abnormal among 28 institutionalized chronically psychotic patients. They were weighed daily for 15 days at 7 a.m. and 4 p.m. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 a.m. weight from the 4 p.m. weight, multiplying the difference by 100, and then dividing the result by the 7 a.m. weight. NDWG was 2·8 ± 1·3% for the 28 study patients, 0·631 ±0·405% for 16 acutely psychotic controls, and 0·511 ±0·351 % for 29 normals. Ninety-three per cent of the study sample had NDWG values above the upper limit of normal. Sex, diagnosis, smoking, baseline weight, blood pressure, and pulse did not explain these observations. NDWG related (N = 28, r = 0·552, P = 0·002) to antipsychotic drug dose. The implications of our findings are discussed.

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Investigation of Polyuria in Schizophrenia

Cited by 40 publications

References 0 publications

Neuroendocrine Factors Influencing Polydipsia in Psychiatric Patients: An Hypothesis

Neuroendocrine Factors Influencing Polydipsia in Psychiatric Patients: An Hypothesis

A translational approach for NMDA receptor profiling as a vulnerability biomarker for depression and schizophrenia

Abnormal diurnal weight gain among chronically psychotic patients contrasted with acutely psychotic patients and normals

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