만성 정신분열병 환자에서 다음증과 물중독 위험군의 임상적 특성 -표 준 화 일중체중증가를 이용하여

Clinical Characteristics of Chronic Schizophrenic Inpatients at Risk of Polydipsia and Water Intoxication Measured with Normalized Diurnal Weight Gain

Objects : Polydipsia and water intoxication among chronic schizophrenic patients is poorly understood and underdiagnosed due to lack of awareness among clinicians, and their clinical characteristics are controversial issues at present. We attempted to identify clinical characteristics of chronic schizphrenic inpatients who had abnormal normalized diurnal weight gain, an economic and easy method for screening the risk group of polydipsia and water intoxication. We also assessed the factors that may contribute to abnormal normalized diumal weight gain. Methods ： One hundred fifiy-six chronic schizophrenic inpatients(from July, 1995 to Octobcr, 1995) at Seoul National Mental Hospital were studied. They were weighed at 7 a.m. and 4 p.m. weekly for 3 weeks. We normalized the diurnal weight gain as a percentage by substracting the 7 a.m. weight from the 4 p,m. weight, multiplying the difference by 100，and dividing the result by the 7 a.m weight. We defined the abnormal normalized diumal weight gain as above 1.2%, according to the previous study of Davidson et al(1976). We estimated current psychotropic medication, prognostic factors of schizophrenia and body type, and compared those with normalized diumal weight gain values. Results : About thirty-six percent of the subjects had abnormal normalized diumal weight gain values. The chronic schizophrenic inpatients with abnormal normalized diumal weight gain were clinically characterized by being male, using low potency antipsychotics，smoking, extended hospitalization and relatively low body mass index score. Conclusions ： We suggest that the risk of polydipsia and water intoxication in chronic schigophrenic inpatients are increased, by being male, using low potency antipsychotics, smoking and having extended hospitalizations and relatively low body mass index score. Therefore in psychiatric practice, clinician s awareness about these correlations are warranted.