Shutty M S, Briscoe L, Sautter S, Leadbetter R A
Western State Hospital, Staunton, VA 24401.
Schizophr Res. 1993 Aug;10(2):125-30. doi: 10.1016/0920-9964(93)90047-m.
We examined the neuropsychological sequelae of water intoxication in nine schizophrenic patients with the syndrome of psychosis, intermittent hyponatremia and polydipsia (PIP). Patients were assessed using a standardized test battery on two occasions following laboratory blood work: once during hyponatremia (serum sodium < 130 mmol/l) and once during normonatremia (serum sodium > 136 mmol/l). Results revealed significant deficits during hyponatremia involving complex information processing skills such as mental flexibility and verbal fluency. In contrast, short-term memory was intact and no deficits in sustained attention or visual-motor scanning were observed. Our results underscore the dramatic fluctuations in neuropsychological functioning due to metabolic and osmotic changes during water loading in PIP syndrome patients. In addition, we found that the neuropsychological effects of hyponatremia are remarkably consistent across patients. These complications, if not recognized, are likely to contribute to worsening of psychosis despite appropriate pharmacological treatment while severely limiting patient ability to actively participate in behavioral interventions.
我们研究了9例患有精神病、间歇性低钠血症和烦渴综合征（PIP）的精神分裂症患者水中毒的神经心理学后遗症。在实验室血液检查后的两个时间点，使用标准化测试组合对患者进行评估：一次是在低钠血症期间（血清钠<130 mmol/L），一次是在血钠正常期间（血清钠>136 mmol/L）。结果显示，低钠血症期间存在显著缺陷，涉及复杂的信息处理技能，如心理灵活性和语言流畅性。相比之下，短期记忆完好无损，未观察到持续注意力或视觉运动扫描方面的缺陷。我们的结果强调了PIP综合征患者在水负荷期间由于代谢和渗透压变化导致的神经心理功能的剧烈波动。此外，我们发现低钠血症对神经心理的影响在患者中非常一致。这些并发症如果不被识别，尽管进行了适当的药物治疗，仍可能导致精神病恶化，同时严重限制患者积极参与行为干预的能力。
