Goldman M B
Department of Psychiatry, Pritzker School of Medicine, University of Chicago, Illinois.
Hosp Community Psychiatry. 1991 May;42(5):488-94. doi: 10.1176/ps.42.5.488.
Many mentally ill patients, particularly those with schizophrenia, have idiopathic or medication-induced disorders of water balance, which include excessive water intake, excessive water excretion, and impaired water excretion. Patients with these disorders manifest polydipsia and polyuria with or without symptomatic hyponatremia (low serum sodium concentration). Other serious sequelae include life-threatening water intoxication. The author reviews the physiology of normal water balance and the mechanism, causes, clinical presentation, and diagnosis of disorders of water balance. Interventions must first focus on identifying reversible factors. Medication-induced water imbalance can usually be reversed without compromising treatment of the underlying psychiatric disorder. A fully effective treatment for idiopathic polydipsia has not been found, although providing optimal treatment for the underlying psychiatric disorder often helps. Monitoring changes in body weight, in conjunction with measures of serum sodium, prevents water intoxication.
许多精神疾病患者，尤其是精神分裂症患者，患有特发性或药物引起的水平衡紊乱，包括水摄入过多、水排泄过多和水排泄受损。患有这些紊乱的患者表现为多饮和多尿，伴有或不伴有症状性低钠血症（血清钠浓度低）。其他严重后果包括危及生命的水中毒。作者回顾了正常水平衡的生理学以及水平衡紊乱的机制、病因、临床表现和诊断。干预措施必须首先侧重于识别可逆因素。药物引起的水平衡失调通常可以在不影响潜在精神疾病治疗的情况下得到纠正。尽管为潜在的精神疾病提供最佳治疗通常会有所帮助，但尚未找到针对特发性多饮的完全有效的治疗方法。监测体重变化并结合血清钠测量可预防水中毒。
