Schizophrenic patients with polydipsia and water intoxication more often have a form of schizophrenia first described by Kraepelin

Bralet, Marie-Cécile; Ton, Trang; Falissard, Bruno

doi:10.1016/j.psychres.2006.11.009

Cited by 23 publications

(15 citation statements)

References 52 publications

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“…Disruption of central oxytocin (OXY) is an appealing candidate given its impact on social functioning in healthy controls and at least some patients with schizophrenia (Gumley et al, 2014). Social function is particularly impaired in polydipsic patients (Bralet et al, 2007). OXY is a nonapeptide closely related to AVP.…”

Section: 0 Are Peripheral Findings Related To Central Dysfunction Umentioning

confidence: 99%

Brain circuit dysfunction in a distinct subset of chronic psychotic patients

Goldman¹

2014

Schizophrenia Research

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Objective To identify the mechanism of unexplained hyponatremia and primary polydipsia in schizophrenia and its relationship to the underlying psychiatric illness. Methods Briefly review previous studies that led to the conclusion the hyponatremia reflects altered hippocampal inhibition of peripheral neuroendocrine secretion. In greater detail, present the evidence supporting the hypothesis that circuit dysfunction associated with the hyponatremia and the polydipsia contributes to the underlying mental disorder. Results Polydipsic patients with and without hyponatremia exhibit enhanced neuroendocrine responses to psychological stress in proportion to structural deformations on their anterior hippocampus, amygdala and anterior hypothalamus. Nonpolydipsic patients exhibit blunted responses and deformations on other hippocampal and amygdala surfaces. The deformations in polydipsic patients are also proportional to diminished peripheral oxytocin levels and impaired facial affect recognition that is reversed by intranasal oxytocin. The anterior hippocampus is at the hub of a circuit that modulates neuroendocrine and other responses to psychological stress and is implicated in schizophrenia. Preliminary data indicate other measures of stress reactivity are also enhanced in polydipsics and that the functional connectivity of the hippocampus with the other structures in this circuitry differs in schizophrenia patients with and without polydipsia. Conclusion Polydipsia may identify a subset of schizophrenia patients whose enhanced stress reactivity contributes to their mental illness. Stress reactivity may be a symptom dimension of chronic psychosis that arises from circuit dysfunction that can modeled in animals. Hence polydipsia could be a biomarker that helps to clarify the pathophysiology and heterogeneity of psychosis as well as identify novel therapies. Clinical investigators should consider obtaining indices of water balance, as these may help them unravel and more concisely interpret their findings. Basic researchers should assess if the polydipsic subset is a patient group particularly suitable to test hypotheses arising from their translational studies.

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Section: 0 Are Peripheral Findings Related To Central Dysfunction Umentioning

confidence: 99%

Brain circuit dysfunction in a distinct subset of chronic psychotic patients

Goldman¹

2014

Schizophrenia Research

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“…Social dysfunction is a prominent and perhaps the most disabling feature of schizophrenia (Addington et al 2010). It has been linked to schizophrenic patients' diminished oxytocin activity (Kéri et al 2009) and is especially prominent in polydipsic patients (Bralet et al 2007;Goldman 2009). Oxytocin restores social dysfunction (Lee et al 2007) (as well as other impairments- Feifel and Reza 1999;Caldwell et al 2009) in animal models of schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Divergent effects of two different doses of intranasal oxytocin on facial affect discrimination in schizophrenic patients with and without polydipsia

et al. 2011

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The effects of 20 IU oxytocin support the hypothesis that altered neuroendocrine function in polydipsic patients contributes to their psychiatric illness. Further studies are warranted to confirm these findings and assess if oxytocin treatment improves social functioning in this subset. This is the first psychopharmacologic study to compare different doses of oxytocin in the same subject, thus the significance of the opposing responses is unclear.

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“…Schizophrenic patients with polydipsia and WI present significantly higher levels of negative symptoms, disorganized symptoms and general symptoms of psychopathology. A significantly higher proportion of these patients have Kraepelinian status (continuous hospitalisation or a complete dependence on others for necessities, such as food, shelter and clothing, inability to work or to be employed and no evidence of a complete remission of symptoms, all lasting over at least 5 years) [3].…”

Section: Discussionmentioning

confidence: 99%