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Psychosomatic Medicine 66:283-286 (2004)
© 2004 American Psychosomatic Society

CASE REPORT

Behavioral and Medical Treatment of Chronic Polydipsia in a Patient With Schizophrenia and Diabetes Insipidus

Erin S. Costanzo, MA, Lisa M. Antes, MD and Alan J. Christensen, PhD

From the University of Iowa, Iowa City, IA.

Address reprint requests to: Alan J. Christensen, PhD, Department of Psychology, E11 Seashore Hall, University of Iowa, Iowa City, IA 52242. E-mail: alan-christensen{at}uiowa.edu

ABSTRACT

OBJECTIVE: This case report describes a novel outpatient behavioral treatment intervention for chronic polydipsia. The program was used in an effort to reduce excessive fluid intake in a woman with chronic paranoid-type schizophrenia who also had a diagnosis of diabetes insipidus.

METHODS: The 12-session individual behavioral intervention incorporated self-monitoring, stimulus control, coping skills training, and reinforcement components.

RESULTS: The patient engaged fully in the treatment program, and she successfully restricted her fluid intake. Her diabetes insipidus could therefore be treated with desmopressin, a medication that requires fluid restriction, and she experienced a concomitant reduction in polyuria and urinary incontinence.

CONCLUSIONS: The outpatient behavioral intervention demonstrated promising outcomes in a chronically mentally ill patient whose polydipsia had underlying psychogenic and physiological components. This case highlights the efficacy of combining behavioral and medical interventions.

Key Words: polydipsia, • polyuria, • schizophrenia, • diabetes insipidus, • behavioral treatment.

Abbreviations: Posm = serum osmolality;; Uosm = urine osmolality.






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