Recognizing and Managing Pyschogenic Polydipsia in Mental Health

Psychogenic polydipsia (PPD) or water intoxication with polyuria and polydipsia is common among patients with psychiatric disorders. Although the underlying pathology is unclear, PPD or drinking more than 3 liters of fluid daily can be a highly disabling and life-threatening condition. In half of the cases, it can lead to mortality because of cerebral edema and central nervous system dysfunction with delirium, seizures, coma, and death. Excessive drinking can accompany other repetitive behaviors in schizophrenic, bipolar, or psychotic patients. A screening program can detect cases early to minimize morbidity and mortality. This article describes the evidence-based screening, evaluation, and management of water intoxication or polydipsia and includes a case study to illustrate evaluation and management.