J. Deleon et al., POLYDIPSIA AND WATER-INTOXICATION IN PSYCHIATRIC-PATIENTS - A REVIEW OF THE EPIDEMIOLOGIC LITERATURE, Biological psychiatry, 35(6), 1994, pp. 408-419
Polydipsia among chronic psychiatric patients is poorly understood and
underdiagnosed. it may have three stages: simple polydipsia, polydips
ia with water intoxication, and physical complications. Epidemiologica
l surveys have used staff reports and polyuria measures to identify po
lydipsic patients. Water intoxication has been screened by chart revie
w, weight, or serum sodium data. According to these surveys, polydipsi
a, not explained by medically induced polyuria, may be present in more
than 20% of chronic inpatients. Up to 5% of chronic inpatients had ep
isodes of water intoxication although mild cases may have been missed.
Single time point surveys show that 29% of polydipsic patients had pr
esented water intoxication. Methodologically limited clinical studies
suggest that polydipsia with water intoxication rather than simple pol
ydipsia may be associated with poor prognosis in schizophrenia. Epidem
iological surveys found polydipsia with water intoxication to be assoc
iated with chronicity, schizophrenia, smoking, some medications, male
gender, and white race. New pathophysiological models need to elucidat
e these findings.