Polydipsia and water intoxication in a long-term psychiatric hospital

Leon, José de; Dadvand, Mahmood; Canuso, Carla M.; Odom-White, Aruby; Stanilla, Joseph K.; Simpson, George M.

doi:10.1016/0006-3223(95)00353-3

Cited by 78 publications

(78 citation statements)

References 7 publications

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“…This study reveals that the age of onset of schizophrenia in the PD group was significantly lower than the NPD group. It is reported that polydipsia appears 5-10 years after the diagnosis of schizophrenia, and water intoxication and other complicated symptoms appears much later (13). However, multiple logistic regressions failed to reveal that the age onset of schizophrenia was a significant factor of polydipsia.…”

Section: Discussionmentioning

confidence: 97%

“…The prevalence varies from 10.8% of psychiatric hospital inpatients (11) to 20% of chronic psychiatric patients, 10% of chronic psychiatric patients were reported to have hyponatremia (12). In addition, polydipsia appears 5-10 years after diagnosis of schizophrenia, and water intoxication and other complicated symptoms appears much later (13).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, polydipsia appears 5-10 years after diagnosis of schizophrenia, and water intoxication and other complicated symptoms appears much later (13).…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Subjective Oral Dryness and Salivary Volume on Polydipsia in Patients with Schizophrenia

et al. 2013

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Aim: For the treatment of polydipsia, medication and occupational therapy are implemented. Since polysipsia canʼt be completely intercepted, patients are isolated or restrained in severe case. Determining the predictive factors of polysipsia may lead to decreasing abnormal water consumption. This study aimed to reveal the influence of subjective oral dryness, salivary volume and other factors including medication on polydipsia in patients with schizophrenia.Methods: Fifty-two patients were divided into two groups: a polydipsia patient (PD) group and a non-polydipsia patient (NPD) group. Their age, medical history, age of onset of schizophrenia, duration of suffering, tobacco, frequency of mouth opening, subjective oral dryness, number of medications, number of xerogenic medications, chlorpromazine (CPZ) equivalent dose, salivary volume and salivary spinability were investigated.Results: The number of total medications was significantly higher than that of the NPD group. Subjective oral dryness of the PD group was rated as ʻsevereʼ compared with the NPD group, and the frequency of mouth opening in the PD group was higher than the NPD group, though there were no significant differences. There was no significant difference in salivary volume and spinability between the two groups. Logistic regression analysis that demonstrated the predictors of polydipsia were tobacco and number of medications.Conclusion: It was shown that the predictors of polydipsia were tobacco and number of medications. The polydipsia may reduce by decreasing medications and quitting tobacco.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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The Influence of Subjective Oral Dryness and Salivary Volume on Polydipsia in Patients with Schizophrenia

et al. 2013

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“…About 20% of all respondents had psychogenic polydipsia, of which about 30% progressed to water intoxication. About 80% of respondents who had diagnosis of psychogenic polydipsia were from the "schizophrenic" group [8,9].…”

Section: Discussionmentioning

confidence: 99%

Severe Hyponatremia and Water Intoxication – Diagnostic Challenge in Department of Emergency Medicine

Pupić-Bakrač

Radović

Pupić‐Bakrač

et al. 2017

Alcoholism and psychiatry research

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-Psychogenic polydipsia is a disorder characterized by compulsive drinking of water in a population of psychiatric patients, most often those suffering from chronic psychosis. It can lead to severe dilutional hyponatremia and water intoxication, which is manifested by cerebral edema and associated neurological symptomatology. A 43 years-old patient was admitted to the Department of Emergency Medicine due to convulsions of the right hand and leg, which began one hour before arrival. During the episode, the patient was conscious, vomited once and had urinary incontinence. In the medical history he had epilepsy, chronic psychosis and moderate mental retardation. Vital parameters were stable, and physical examination did not reveal any associated pathological signs. Samples for laboratory analysis were taken and therapy with infusions of Diasepam (20 mg) included, to which patient was resistant. By heteroanamnesis it was acknowledged that in the last few days he spent more time than usual drinking water. Reviewing laboratory results it was found out that sodium concentration was 98 mmol/L. We began the gradual correction of sodium, after which the patient reached the full extent of recovery. Water intoxication is an emergency condition that is in clinical practice often mistaken for other neurological and internal emergency states, because of its non-specific symptomatology. With timely diagnosis and application of adequate treatment, recovery is complete.

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“…In 3% of patients with chronic schizophrenia, a primary disorder in water elimination can be observed, which leads to recurring hyponatremia and hypoosmolemia and, secondarily, life-threatening episodes of water intoxication [1]. Hyponatremia in schizophrenics may be caused by primary polydipsia (excessive liquid drinking) [1], periods of starvation [2], and represent a side effect of antipsychotic drugs [3] or mood altering drugs (in particular, carbamazepine and selective serotonin reuptake inhibitors) [4,5].…”

Section: Purposementioning

confidence: 99%

Reduction in the volume of the front part of the hippocampus in schizophrenics with hyponatremia on hospital admission

Woźniak¹,

Olędzka-Oręziak²,

Poniatowska³

et al. 2017

ppn

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Purpose: Evaluation of the volume of the front part of hippocampi in schizophrenics with hyponatremia on psychiatric ward admission. Methods: Hippocampal volumes were compared across a group of 11 schizophrenics with hyponatremia and 22 patients with normonatremia, in the whole groups and in 11 couples matched in terms of gender, age and the disease duration. The groups were characterised in terms of demographic (gender, age) and clinical (course of illness, pharmacotherapy, tobacco smoking) features. All the participants were right-handed. The hippocampal volumes were manually measured on the basis of the magnetic resonance imaging (MRI), using manual contouring, separately and jointly for the right and left hippocampus, then the obtained results were standardised for the maximum transverse brain diameter (MTBD), the maximum trans-pineal inner table diameter (LTID) or the height. Results: No relation was found between hyponatremia and the MTBD. In patients with hyponatremia, a smaller volume of the left hippocampus was observed, both using direct measurement and after standardisation for the MTBD. The analysis of regression indicates a relation model, in which the reduction in the left hippocampus is explained by the covariance of hyponatremia and MTBD values. Conclusions: Dependency of reduction in the volume of the left hippocampus on hyponatremia observed in patients with schizophrenia encourages a number of pathogenic hypotheses whose interpretation, however, urges caution as the phenomenon itself is complex, and methodological limitations of the undertaken research are present.

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Polydipsia and water intoxication in a long-term psychiatric hospital

Cited by 78 publications

References 7 publications

The Influence of Subjective Oral Dryness and Salivary Volume on Polydipsia in Patients with Schizophrenia

The Influence of Subjective Oral Dryness and Salivary Volume on Polydipsia in Patients with Schizophrenia

Severe Hyponatremia and Water Intoxication – Diagnostic Challenge in Department of Emergency Medicine

Reduction in the volume of the front part of the hippocampus in schizophrenics with hyponatremia on hospital admission

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