심인성 다음증의 임상적 특징과 치료
Psychogenic Polydipsia: Clinical Features and Management
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초록
Psychogenic polydipsia is a clinical condition characterized by an excessive fluid intake and excretion of urine exceeding 40-50 ml/kg body weight, excluding reasons for secondary polydipsia. It occurs commonly in psychiatric patients and is most likely to be seen in schizophrenia. The underlying pathophysiology of this syndrome remains unclear and complex factors have been reported to be associated including medication, hypothalamic defect. It can progress to life threatening state of water intoxication, which symptoms are confusion, lethargy, psychosis, seizure or death. Evaluation of psychogenic polydipsia includes a comprehensive search for other medical reasons of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities lack reports of replicated efficacy, but may include water restriction, behavioral approach and medications including clozapine. Recent human neuroimaging studies are revealing complex mechanisms of controlling thirst and drinking. Further studies in needed to provide better understanding of the pathophysiology and treatment guidelines for psychogenic polydipsia.
Abstract
Psychogenic polydipsia is a clinical condition characterized by an excessive fluid intake and excretion of urine exceeding 40-50 ml/kg body weight, excluding reasons for secondary polydipsia. It occurs commonly in psychiatric patients and is most likely to be seen in schizophrenia. The underlying pathophysiology of this syndrome remains unclear and complex factors have been reported to be associated including medication, hypothalamic defect. It can progress to life threatening state of water intoxication, which symptoms are confusion, lethargy, psychosis, seizure or death. Evaluation of psychogenic polydipsia includes a comprehensive search for other medical reasons of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities lack reports of replicated efficacy, but may include water restriction, behavioral approach and medications including clozapine. Recent human neuroimaging studies are revealing complex mechanisms of controlling thirst and drinking. Further studies in needed to provide better understanding of the pathophysiology and treatment guidelines for psychogenic polydipsia.
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