Many psychiatric patients have polydipsia and polyuria without identifiable underlying medical causes. Hyponatremia develops in some polydipsic patients and can progress to water intoxicaation. This syndrome is called psychogenic polydipsia,
which
is
typically associated with a broad spectrum of psychopathology, from mild neurosis to psychosis.
We present two cases of psychogenic polydipsia and a brief review of the literature concerning psychogenic polydipsia.
Case 1 was consistently polydipsic for past 3 years but didn't develop water intoxication. This patient reported the polydipsia to increase with anxiety, and to lessen when it iomproved.
Case 2 was polydipsic under acute anxiety state and became hyponatremic. He also showed evidence of inappropriate antidiuretic hormone, and developed frank intoxication, although the duration of polydipsia was short. This patients wan an
alcoholic
and a
heavy smoker.
The term psychogenic polydipsia is defined, and its suggested etiology, diagnosis, differential diagnosis and treatments are discussed.
We also discuss whether water drinking is anxiolytic
Since excessive water consumption can be dangerous, the fluid intake of patients with a polydipsia should be closely monitered.
|