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Water Intoxication in Psychiatric Patients

Published online by Cambridge University Press:  29 January 2018

Satnam Singh
Affiliation:
Department of Psychological Medicine, University Hospital of Wales, Heath Park, Cardiff, South Wales, CF4 4XW
Henrietta Bullard
Affiliation:
The Central Hospital, Near Warwick, CV35 7EE
Hugh Freeman
Affiliation:
Salford Health Authority, Hope Hospital, Salford, M6 8HD

Summary

Compulsive water drinking is associated with a broad spectrum of psychopathology, from mild neurosis to psychosis. Since the normal kidney is capable of excreting large volumes of fluid rapidly, water intoxication requires both a pathological basis and a psychiatric explanation of why so much water is being taken. Excessive water consumption can be dangerous, so that the fluid intake of patients with a history of polyuria together with a low urinary specific gravity should be closely observed. Four cases of water intoxication resulting from psychogenic polydipsia are described, three of them in chronic schizophrenics, where inappropriate ADH secretion might represent part of the psychosis.

Type
Research Article
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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References

Arieff, A. E. & Guisado, R. (1976) Effects on the central nervous system of hyponatraemic states. Kidney International, 10, 104116.Google Scholar
Barahal, H. S. (1938) Water Intoxication in a mental case. Psychiatric Quarterly, 12, 767771.Google Scholar
Barlow, E. D. & De Wardener, H. E. (1959) Compulsive water drinking. Quarterly Journal of Medicine, 28, 235258.Google Scholar
Bartter, F. C. & Schwartz, W. B. (1967) The Syndrome of Inappropriate Secretion of Antidiuretic Hormone. American Journal of Medicine, 42, 790806.Google Scholar
Blum, A., Tempey, F. W. & Lynch, W. J. (1983) Somatic findings in patients with psychogenic polydipsia. Journal of Clinical Psychiatry, 44, 5556.Google Scholar
Chinn, T. A. (1974) Compulsive water drinking. Journal of Nervous and Mental Diseases, 158, 7880.Google Scholar
Di Maio, V. J. M. & Di Maio, S. J. (1980) Fatal water-intoxication in a case of psychogenic polydipsia. Journal of Forensic Sciences, 25, 332335.Google Scholar
Edelstein, E. L. (1973) A case of water dependence. British Journal of Addiction, 68, 365367.Google ScholarPubMed
Finkel, R. M. (1972) Hyponatraemia. Medical Clinics of North America, 56, 645649.Google Scholar
Fowler, R. C., Kronfol, Z. A. & Perry, P. J. (1977) Water intoxication, psychosis and inappropriate secretion of antidiuretic hormone. Archives of General Psychiatry, 34, 10971099.Google Scholar
Hariprasad, M. K. & Eisenger, R. P. (1979) Water intoxication in psychotic patients (C). American Journal of Psychiatry, 136, 1227.Google Scholar
Hobson, J. A. & English, J. T. (1963) Self-induced water intoxication. Annals of Internal Medicine, 58, 324332.Google Scholar
Jose, C. J., Mehta, S. & Perez-Cruet, J. (1979) The Syndrome of Inappropriate Secretion of Antidiuretic Hormone. Canadian Journal of Psychiatry, 24, 225231.Google Scholar
Khamnei, A. K. (1984) Psychosis, Inappropriate Antidiuretic Hormone Secretion, and water intoxication. The Lancet, i, 963.Google Scholar
Kramer, D. S. & Drake, M. E. Jr. (1983) Acute psychosis, polydipsia and inappropriate Secretion of Antidiuretic Hormone. American Journal of Medicine, 75, 712714.Google Scholar
Lancet, (1953) Lead Article, “Water intoxication”, 264, 425426.Google Scholar
Noonan, J. P. A. & Ananth, J. (1977) Compulsive water drinking and water intoxication. Comprehensive Psychiatry, 18, 183187.Google Scholar
Perez-Cruet, J. (1979) Incidence and morbidity of self-induced water intoxication in state mental hospital. American Journal of Psychiatry, 136, 221222.Google Scholar
Raskind, M. A. (1974) Psychosis, polydipsia and water intoxication; report of a fatal case. Archives of General Psychiatry, 30, 112114.Google Scholar
Raskind, M. A., Orenstein, H. & Christopher, T. G. (1975) Acute psychosis, water ingestion and inappropriate Antidiuretic Hormone Secretion. American Journal of Psychiatry, 132, 907910.Google Scholar
Rendell, M., McGrane, D. & Cuesta, M. (1978) Fatal compulsive water drinking. Journal of American Medical Association, 240, 25572559.Google Scholar
Rosenbaum, J. F., Rothman, J. S. & Murray, G. B. (1979) Psychosis and water intoxication. Journal of Clinical Psychiatry, 40, 289291.Google Scholar
Rowntree, L. G. (1923) Water intoxication. Archives of Internal Medicine, 32, 154174.Google Scholar
Shalev, E., Goldstein, D. & Zuckerman, H. (1980) Compulsive water drinking in pregnancy. International Journal of Gynaecology and Obstetrics, 18, 465467.Google Scholar
Shevitz, S. A., Jameson, R. C., Petrie, W. M. & Crook, J. E. (1980) Single case study of compulsive water drinking: treatment with high dose of propranolol. Journal of Nervous and Mental Diseases, 168, 246248.Google Scholar
Smith, W. O. & Clark, M. L. (1980) Self-induced water intoxication in schizophrenic patients. American Journal of Psychiatry, 137, 10551060.Google ScholarPubMed
Stevko, R. M., Balsley, M. & Segar, E. W. (1968) Primary polydipsia, compulsive water drinking. Journal of Paediatrics, 73, 845.Google Scholar
Walls, L. L., Supinski, C. R., Cotton, W. K. & McFadden, J. W. (1977) Compulsive water drinking—a review with report of an additional case. Journal of Family Practice, 5, 531533.Google ScholarPubMed
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