A fatal case of water intoxication in a schizophrenic patient

Article Abstract:

A case history is presented of 40-year-old schizophrenic woman who apparently died of water intoxication, according to autopsy findings. A diagnosis of schizophrenia at age 28 was followed by a 12-year illness course that included 13 psychiatric hospitalizations with outbreaks of hallucinations and delusions. At age 39, the woman was diagnosed with diabetes mellitus and was given oral hypoglycemics to control her blood sugar levels. There was no history of low blood pressure. In 1984, at age 40, she was readmitted to the hospital for paranoia, and was also suffering from polydipsia (persistent, excessive thirst). The patient became confused, then comatose, and was transferred to a general hospital and treated with an intravenous dextrose-saline drip. Sodium and urine osmolality (concentration) levels were low, but all other laboratory and radiographic tests were normal; the patient was stabilized and released. Five months later, she had a recurrence of paranoid delusions and was readmitted to the psychiatric ward. After convulsions began, the woman fell and hit her head and was again transferred to a general hospital where she was treated for acute pulmonary edema (fluid on the lungs). One hour later, cardiac arrest occurred, and the woman died. The post-mortem diagnosis of water intoxication was based on clinical findings of polydipsia, confusion, convulsions, and biochemical findings including high-blood sugar levels and low serum and urine osmolality recorded during her previous hospitalization. Cerebral edema was also found. The patient's death many have been prevented with different treatment. Laboratory findings of abnormally concentrated urine with hypo-osmolar plasma levels are indicators of SIADH (inappropriate antidiuretic hormone), which is related to polydipsia. During her last hospital admittance, the patient's urine osmolality was not measured. This case illustrates the importance of regular blood and urine testing in making an accurate diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Diabetes, Diabetes mellitus, Water intoxication, Overhydration

---

A genetic model compatible with a dimensional view of schizophrenia

Article Abstract:

Despite a multitude of research on the possible causes of schizophrenia, there has been no consensus as to what the cause or causes may be. However, one fact has emerged fairly consistently; genetics are almost certainly involved to some degree. Even so, relatively little is known about the genetic mechanism by which schizophrenia may be carried and transmitted. The prevailing views to date are based on the single gene model, or the medical model, which seeks to find a purely genetic cause, and the polygenic theories which propose that schizophrenia is a product of biological (genetic) and environmental conditions. While the polygenic theories are sometimes difficult to test, new techniques have made it possible to derive direct evidence for the genetic theory. A genetic model of schizophrenia is proposed here that is compatible with the polygenic view. It is suggested that brain function and mental functioning are products of steps that are controlled by genes, and that a block anywhere in the sequence of steps can lead to schizophrenia-like symptoms. The block can occur due to mutations of a gene, and depending upon the specific mutation, the effects will vary. There are interactions between genes and the environment as well, and interactions between genes and mental functioning will ultimately be determined by the product of all of these interactions. This is a model that is readily accepted by developmental geneticists and fully accounts for the effect of environmental-gene interactions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mental illness, Mental disorders

---

Schizophrenia and Marfan syndrome

Article Abstract:

The hypothesis of a genetic basis for schizophrenia has received further support by the statistically significant discovery of five schizophrenics and three of their first-degree relatives. All of these individuals were schizophrenic, of Ashkenazi or Sephardic Jewish origin, lived in Israel, and also had a genetic disease known as Marfan syndrome. A condition that primarily affects Jews, Marfan syndrome is a disease of the body's connective tissues, and in some cases can be fatal, especially if it affects the main systemic arteries. Statistical analysis of the odds of finding such a collection of patients with both disorders suggests that the link between this particular form of schizophrenia and the genetic defect involved in Marfan syndrome is too strong to ignore. It is posited that both schizophrenia and Marfan syndrome are genetically heterogeneous (caused by any of various gene abnormalities). The author further speculates that when and if the Marfan syndrome gene is located, it may be profitable to conduct scientific inquiry into whether the same gene locus could be responsible for at least one form of schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Israel, Statistics, Schizophrenics, Marfan syndrome

Similar abstracts:

• Abstracts: A reappraisal of the need for autologous blood donation in the obstetric patient. Vaginal birth after cesarean section: a reappraisal of risk
• Abstracts: The role of the chest roentgenogram in febrile neutropenic patients. Sulbactam-induced hyperpyrexia
• Abstracts: Patient psychopathology and expressed emotion in schizophrenia. Mentally retarded criminal offenders in Denmark
• Abstracts: Drug prescribing for schizophrenic out-patients on depot injections: repeat surveys over 18 years. Kluver-Bucy syndrome and psychiatric illness

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.