Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-02T18:56:01.120Z Has data issue: false hasContentIssue false
  • English
  • Français

Abnormal diurnal weight gain among chronically psychotic patients contrasted with acutely psychotic patients and normals

Published online by Cambridge University Press:  09 July 2009

W. V. R. Vieweg ,
L. S. Godleski ,
M. Mitchell ,
P. L. Hundley  and
G. R. Yank
W. V. R. Vieweg*
Affiliation:
Clinical Evaluation Service, Western State Hospital, Department of Mental Health and Mental Retardation, Commonwealth of Virginia and the Department of Behavioral Medicine and Psychiatry and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
L. S. Godleski
Affiliation:
Clinical Evaluation Service, Western State Hospital, Department of Mental Health and Mental Retardation, Commonwealth of Virginia and the Department of Behavioral Medicine and Psychiatry and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
M. Mitchell
Affiliation:
Clinical Evaluation Service, Western State Hospital, Department of Mental Health and Mental Retardation, Commonwealth of Virginia and the Department of Behavioral Medicine and Psychiatry and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
P. L. Hundley
Affiliation:
Clinical Evaluation Service, Western State Hospital, Department of Mental Health and Mental Retardation, Commonwealth of Virginia and the Department of Behavioral Medicine and Psychiatry and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
G. R. Yank
Affiliation:
Clinical Evaluation Service, Western State Hospital, Department of Mental Health and Mental Retardation, Commonwealth of Virginia and the Department of Behavioral Medicine and Psychiatry and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
*
1Address for correspondence: Dr W. V. R. Vieweg, Western Stale Hospital, Box 2500, Staunton, VA 24401, USA.
Get access Rights & Permissions [Opens in a new window]

Synopsis

We found diurnal weight gain to be abnormal among 28 institutionalized chronically psychotic patients. They were weighed daily for 15 days at 7 a.m. and 4 p.m. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 a.m. weight from the 4 p.m. weight, multiplying the difference by 100, and then dividing the result by the 7 a.m. weight. NDWG was 2·8 ± 1·3% for the 28 study patients, 0·631 ±0·405% for 16 acutely psychotic controls, and 0·511 ±0·351 % for 29 normals. Ninety-three per cent of the study sample had NDWG values above the upper limit of normal. Sex, diagnosis, smoking, baseline weight, blood pressure, and pulse did not explain these observations. NDWG related (N = 28, r = 0·552, P = 0·002) to antipsychotic drug dose. The implications of our findings are discussed.

Type
Research Article
Information
Psychological Medicine , Volume 19 , Issue 1 , February 1989 , pp. 105 - 109
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (fourth edn.), DSM-III-R. American Psychiatric Association: Washington.Google Scholar
Berne, R. M. & Levy, M. N. (1972). Cardiovascular Physiology, pp. 89–91. C. V. Mosby: Saint Louis.Google Scholar
Blum, A. (1984). The possible role of tobacco cigarette smoking in hyponatremia of long-term psychiatric patients. Journal of the American Medical Association 252, 2864–2865.CrossRefGoogle ScholarPubMed
Davidson, C., Smith, D. & Morgan, D. B. (1976) Diurnal pattern of water and electrolyte excretion and body weight in idiopathic orthostatic hypotension. American Journal of Medicine 61, 709–715.CrossRefGoogle ScholarPubMed
Delva, N. J. & Crammer, J. L. (1988). Polydipsia in chronic psychiatric patients: body weight and plasma sodium. British Journal of Psychiatry 152, 242–245.CrossRefGoogle ScholarPubMed
Gelenberg, A. J. (1983). Psychosis. In The Practitioner's Guide to Psychoactive Drugs (ed. Bassuk, E. L., Schoonover, S. C. and Gelenberg, A. J.), pp. 167–201. Plenum: New York.Google Scholar
Gleadhill, I. C., Smith, T. A. & Yium, J. J. (1982). Hyponatremia in patients with schizophrenia. Southern Medical Journal, 75, 426–428.CrossRefGoogle ScholarPubMed
Hoskins, R. G. (1933). Schizophrenia from the physiological point of view. Annals of Internal Medicine 7, 445–456.Google Scholar
Hoskins, R. G. & Sleeper, F. H. (1933). Organic functions in schizophrenia. Archives of Neurology and Psychiatry 30, 123–140.Google Scholar
Koczapski, A., Ibraheem, S., Paredes, J. & Ledwidge, B. (1985) Diurnal variations in hyponatremia and body weight in chronic schizophrenics with self-induced water intoxication. Journal of Clinical Investigative Medicine 8, A86.Google Scholar
Koczapski, A. B., Ibraheem, S., Ashby, Y. T., Paredes, J., Jones, B. D. & Ancill, R. (1987). Early diagnosis of water intoxication by monitoring diurnal variations in body weight. American Journal of Psychiatry 144, 1626.Google ScholarPubMed
Raskind, M. A., Courtney, N., Murburg, M. M., Backus, F. I., Bokan, J. A., Ries, R. K., Dorsa, D. M. & Weitzman, R. E. (1987). Antipsychotic drugs and plasma vasopressin in normals and acute schizophrenic patients. Biological Psychiatry 22, 453–462.CrossRefGoogle ScholarPubMed
Rowe, J. W., Kilgore, A. & Robertson, G. L. (1980). Evidence in man that cigarette smoking induces vasopressin release via an airway-specific mechanism. Journal of Clinical Endocrinology and Metabolism 51, 170–173.CrossRefGoogle ScholarPubMed
Sandifer, M. G. (1983). Hyponatremia due to psychotropic drugs. Journal of Clinical Psychiatry 44, 301–303.Google Scholar
Sleeper, F. H. (1935). Investigation of polyuria in schizophrenia. American Journal of Psychiatry 91, 1019–1031.CrossRefGoogle Scholar
Sleeper, F. H. & Jellinek, E. M. (1936). A comparative physiologic, psychologic, and psychiatric study of polyuric and nonpolyuric schizophrenic patients. Journal of Nervous and Mental Disease 83, 557–563.Google Scholar
Vieweg, W. V. R., David, J. J., Rowe, W. T., Peach, M. J., Veldhuis, J D., Kaiser, D. L. & Spradlin, W. W. (1985 a). Psychogenic polydipsia and water intoxication – concepts that have failed. Biological Psychiatry 20, 1308–1320.CrossRefGoogle ScholarPubMed
Vieweg, W. V. R., David, J. J., Rowe, W. T., Wampler, G. J., Burns, W. J. & Spradlin, W. W. (1985 b). Death from self-induced water intoxication among patients with schizophrenic disorders. Journal of Nervous and Mental Disease 173, 161–165.CrossRefGoogle ScholarPubMed
Vieweg, W. V. R., David, J. J., Rowe, W. T., Peach, M. J., Veldhuis, J. D. & Spradlin, W. W. (1986 a). Correlation of cigarette-induced increase in serum nicotine levels with arginine vasopressin concentration in the syndrome of self-induced water intoxication and psychosis (SIWIP). Canadian Journal of Psychiatry 31, 108–111.CrossRefGoogle ScholarPubMed
Vieweg, W. V. R., David, J. J., Rowe, W. T. & Spradlin, W. W. (1986 b). Diurnal variation of urinary excretion for patients with psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome). Biological Psychiatry 21, 1031–1042.CrossRefGoogle ScholarPubMed
Vieweg, V., Godleski, L. & Yank, G. (1987 a). Diurnal weight gain as an index of polyuria and hyponatremia among chronically psychotic patients. Neuroendocrinology Letters 9, 218.Google Scholar
Vieweg, V., Godleski, L. & Yank, G (1987 b). Diurnal variation of serum sodium and ADH among patients with psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome). Neuroendocrinology Letters 9, 219.Google Scholar
Vieweg, V., Godleski, L. & Yank, G (1987 c). Hyponatremia and volume expansion in psychosis. Neuroendocrinology Letters 9, 219.Google Scholar
Vieweg, W. V. R., Yank, G. R., Rowe, W. T & Hovermale, L. S. (1987 d). Diurnal variation of sodium and water metabolism among patients with psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome). Biological Psychiatry 22, 224–227.CrossRefGoogle ScholarPubMed
Vieweg, W. V. R., Godleski, L. S., Graham, P., Barber, J., Goldman, F., Kellogg, E., Bayliss, E. V., Glick, J., Hundley, P. L. & Yank, G. R. (1988 a). Abnormal diurnal weight gain among long-term patients with schizophrenic disorders. Schizophrenia Research 1, 67–71.CrossRefGoogle ScholarPubMed
Vieweg, W. V. R., Weiss, N. M., David, J. J., Rowe, W. T., Godleski, L. S. & Spradlin, W. W. (1988 b). Treatment of psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome) using lithium and phenytoin. Biological Psychiatry 23, 25–30.CrossRefGoogle ScholarPubMed
Waldinger, R. J. (1984). Psychiatry for Medical Students, p. 356. American Psychiatric Press: Washington.Google Scholar