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Drinking, Thirst and Water Intoxication

Published online by Cambridge University Press:  02 January 2018

John L. Crammer*
Affiliation:
Reader Emeritus in Biological Psychiatry, Institute of Psychiatry (University of London), De Crespigny Park, London SE5 8AF

Abstract

Drinking is an activity determined partly by oropharyngeal stimulation and gastrointestinal sensations as well as biochemical changes, and thirst need not be involved. It is sometimes disturbed in mania or depression. Overdrinking (polydipsia) is common in long-stay in-patients, but only gives rise to water intoxication when there is a variable functional renal abnormality such as SIADH causing water retention. In contrast, in affective disorders, disturbance of sodium retention may be seen, possibly representing failure of nervous vascular control as part of the mental illness.

Type
Papers
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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References

Bourgeois, P., Leys, D. & Petit, H. (1985) Water intoxication in psychiatric patients. British Journal of Psychiatry, 147, 323324.Google Scholar
Bremner, A. J. & Regan, A. (1991) Intoxicated by water: polydipsia and water intoxication in a mental handicap hospital. British Journal of Psychiatry, 158, 244250.Google Scholar
Crammer, J. L. (1959) Water and sodium in two psychotics. Lancet, i, 11221126.Google Scholar
Crammer, J. L. (1962) Electrolytes and mental state. In Aspects of Psychiatric Research (eds Richter, D., Tanner, J. M., Lord Taylor, , et al). London: Oxford University Press.Google Scholar
Crammer, J. L. (1983) Nutritional disorders. In Handbook of Psychiatry, 2 (eds Lader, M. & Shepherd, M.). Cambridge: Cambridge University Press.Google Scholar
Crammer, J. L. (1986) Disturbance of water and sodium in a manic depressive illness. British Journal of Psychiatry, 149, 337345.Google Scholar
Delva, N. J. & Crammer, J. L. (1988) Polydipsia in chronic psychiatric patients: body weight and plasma sodium. British Journal of Psychiatry, 152, 242245.Google Scholar
Delva, N. J., Crammer, J. L., Jarzylo, S. V., et al (1989) Osteopenia, pathological fractures and increased urinary calcium excretion in schizophrenic patients with polydipsia. Biological Psychiatry, 26, 781793.CrossRefGoogle ScholarPubMed
Delva, N. J., Lawson, J. S., Lightman, S. L., et al (1990) Vasopressin in chronic psychiatric patients with primary polydipsia. British Journal of Psychiatry, 157, 703712.Google Scholar
Demanet, J. C., Bonnins, M., Bleiberg, H., et al (1971) Coma due to water intoxication in beer drinkers. Lancet, ii, 11151117.Google Scholar
Dingman, J. F., Benirschke, K. & Thorn, G. W. (1957) Studies of neurohypophyseal function in man. American Journal of Medicine, 23, 226238.Google Scholar
Dubovsky, S. L., Grabon, S., Berl, T., et al (1973) Syndrome of inappropriate secretion of ADH with exacerbated psychosis. Annals of Internal Medicine, 79, 551554.Google Scholar
Farley, P. C., Lau, K.-Y. & Suba, S. (1986) Severe hypernatremia in a patient with psychiatric illness. Archives of Internal Medicine, 146, 12141215.Google Scholar
Fourman, P. & Leeson, P. M. (1959) Thirst and polyuria, with a note on the effects of potassium deficiency and calcium excess. Lancet, i, 268271.Google Scholar
Goldman, M., Luchins, D. J. & Robertson, G. L. (1988) Mechanisms of altered water metabolism in psychotic patients with polydipsia and hyponatremia. New England Journal of Medicine, 318, 397403.CrossRefGoogle ScholarPubMed
Hilden, T. & Svendsen, T. L. (1975) Electrolyte disturbance in beer drinkers. Lancet, ii, 245246.Google Scholar
Hobson, J. A. & English, J. T. (1963) Self-induced water intoxication. Annals of Internal Medicine, 58, 324331.Google Scholar
Jana, D. K. & Romano-Jana, L. (1973) Hypernatremic psychosis in the elderly. Journal of the American Geriatric Society, 21, 473477.Google Scholar
Keshavan, M. S. & Keshavan, A. (1986) Polydipsia and mood disorder without water intoxication. British Medical Journal, 292, 489.Google Scholar
Kokko, J. P. & Tanner, T. L. (1990) Fluids and Electrolytes (2nd edn). Philadelphia: Saunders.Google Scholar
Lee, S., Chow, C. L. & Koo, L. C. (1989) Altered state of consciousness in a compulsive water drinker. British Journal of Psychiatry, 154, 556558.Google Scholar
Naylor, G. J., Smith, A. H. W., Dick, E. G., et al (1980) Erythrocyte membrane cation carrier in manic-depressive psychosis. Psychological Medicine, 10, 521525.Google Scholar
Raskind, M. A., Orenstein, H. & Christopher, T. G. (1975) Acute psychosis, increased water ingestion and inappropriate ADH secretion. American Journal of Psychiatry, 132, 907910.Google Scholar
Rolls, B. J. & Rolls, E. T. (1982) Thirst. Cambridge: Cambridge University Press.Google Scholar
Santy, P. A. & Schwartz, M. B. (1983) Hyponatremia disguised as an acute manic episode. Hospital and Community Psychiatry, 34, 11561157.Google Scholar
Seldin, D. W. & Giebisch, G. (1985) The Kidney: Physiology and Pathology, vol. 2. New York: Raven.Google Scholar
Singh, S., Padi, M. H., Bullard, H., et al (1985) Water intoxication in psychiatric patients. British Journal of Psychiatry, 146, 127131.Google Scholar
Smith, W. O. & Clark, M. L. (1980) Self-induced water intoxication in psychiatric patients. American Journal of Psychiatry, 137, 10551056.Google Scholar
Vieweg, W. V. R., Rowe, W. T., David, J. J., et al (1987) Self-induced water intoxication and psychosis (SWIP); subcategory of the syndrome of inappropriate antidiuresis (SIADH). Psychiatric Medicine, 4, 277290.Google Scholar
Von Stockert, F. G. (1958) Pathophysiologic einer im 48–stunden rhythmus verlaufenden periodischen kaqtatonie. Confinia Neurologica (Basel), 18, 183188.Google Scholar
Wynn, V. (1956) Water intoxication and serum hypotonicity. Metabolism, 5, 490499.Google ScholarPubMed
Zubenko, G. S., Altesman, R. I., Cassidy, J. W., et al (1984) Disturbances of thirst and water homeostasis in patients with affective illness. American Journal of Psychiatry, 141, 436437.Google Scholar
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