Article

Psychogenic Polydidsia Review: Etiology, Differential, and Treatment

Department of Neuropsychiatry and Behavioral Sciences, University of South Carolina School of Medicine, Columbia, SC 29203, USA.
Current Psychiatry Reports (Impact Factor: 3.05). 07/2007; 9(3):236-41. DOI: 10.1007/s11920-007-0025-7
Source: PubMed

ABSTRACT Psychogenic polydipsia (PPD), a clinical disorder characterized by polyuria and polydipsia, is a common occurrence in inpatients with psychiatric disorders. The underlying pathophysiology of this syndrome is unclear, and multiple factors have been implicated, including a hypothalamic defect and adverse medication effects. Hyponatremia in PPD can progress to water intoxication and is characterized by symptoms of confusion, lethargy, and psychosis, and seizures or death. Evaluation of psychiatric patients with polydipsia warrants a comprehensive evaluation for other medical causes of polydipsia, polyuria, hyponatremia, and the syndrome of inappropriate secretion of antidiuretic hormone. The management strategy in psychiatric patients should include fluid restriction and behavioral and pharmacologic modalities.

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    • "In normovolemic hyponatremia, the shortlist of diagnostic possibilities includes SIADH, hypothyroidism , adrenal insufficiency, or psychogenic polydipsia. Low urine sodium and low urine osmolality imply psychogenic polydipsia (Dundas et al., 2007). If urine sodium and osmolality are high, then a TSH and cosyntropin stimulation test will evaluate whether thyroid and adrenal function are depressed. "
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