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Hiponatremia in the practice of a psychiatrist. Part 2: psychogenic polydipsia

Abstract

Objective. The study is the second part of the literature review on hyponatremia in patients with diagnosed mental disorders. This article focuses on psychogenic polydipsia as, along with the SIADH, one of the two most common causes of hyponatremia in the mentioned group of patients.

Method: The literature review was based on searching the Medline, the Google Scholar and the Ebsco databases in Polish and English by entering the following phrases: psychogenic polydipsia, the psychosis – intermittent hyponatremia – polydipsia syndrome, water intoxication.

Discussion: Psychogenic polydipsia occurs in up to 25% of patients treated for mental disorders. It most frequently concerns patients with schizophrenia. 30% of patients with psychogenic polydipsia suffer from hyponatremia with or without symptoms of water intoxication. In the etiology of psychogenic polydipsia, the influence of dopaminergic and noradrenergic neurotransmission has been considered, as well as angiotensin, which is claimed to have dipsogenic properties. In order to reduce the severity of the disorder, attempts have been made to administer the following groups of medications: β-blockers, opioid receptor antagonists, angiotensin convertase inhibitors and angiotensin receptor antagonists. Other methods include replacing classic antipsychotic drugs with clozapine. There are also reports of a reduced severity of polydipsia with hyponatremia after introducing risperidone and olanzapine. Preventing episodes of water intoxication in patients with psychogenic polydipsia requires the monitoring of their body weight and a suitable reduction of fluid intake by them.

Results: Mentally ill patients, especially those with chronic schizophrenia, should be monitored for psychogenic polydipsia and the concomitant hyponatremia.

Open access
The society’s perception of suicide

Abstract

Introduction: On account of its radical character, suicide is differently perceived by the society. The consequence of this phenomenon is the issue of moral evaluation by the society in the practical aspects of daily life, such as religious, psychological and social ones. Regarding society’s complexity, it is understandable that the knowledge and the evaluation of this act amongst people are different.

Materials and methods: In the study a method of the diagnostic survey was applied. The questionnaire was conducted amongst 168 individuals ranging from 18 to 49 years of age. The study involved 69 women and 99 men. The arranged personal data questionnaire served as the evaluation of perceiving the suicidal act and people’s knowledge about this occurrence.

Results: Respondents claim that suicidal behaviours affect 72.5% of young people, and 22.7% of adult men. Large group of the study participants had personal experience with individuals after a suicide attempt (41.92%). As many as 49.7% of individuals are fierce opponents of suicidal acts while 46.1% are of an opinion that ‘the one who commits suicide should not be condemned or judged’.

Conclusions: Respondents present vast knowledge about the universality of suicide phenomenon and its most frequent causes. They are against such behaviour, but do not condemn individuals who committed this act. The study participants show understanding of ways to prevent suicide.

Open access
Relationship between antipsychotic medication, obesity and cognitive functions

, Prim Care Companion J Clin Psychiatry. 2004; 6(2): 8–13 25. Sicras-Mainar A, Navarro-Artieda R, Rejas-Gutiérrez J, Blanca-Tamayo M. Relationship between obesity and antipsychotic drug use in the adult population: A longitudinal, retrospective claim database study in Primary Care settings, Neuropsychiatr Dis Treat. 2008; 4(1): 219–226 26. Zhao G, Ford ES, Li Ch, Tsai J, Dhingra S, Balluz LS. Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: national health and nutrition examination survey 2005-2006, BMC

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