Original paper

European Archives of Psychiatry and Clinical Neuroscience

, Volume 248, Issue 4, pp 180-188

Abnormal physiological conditions in acute schizophrenic patients on emergency admission: dehydration, hypokalemia, leukocytosis and elevated serum muscle enzymes

  • K. HattaAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Takeo TakahashiAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Hiroyuki NakamuraAffiliated withDepartment of Public Health, Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa, Japan
  • , Hisato YamashiroAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Hirohisa EndoAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Senta FujiiAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Goro FukamiAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Kanji MasuiAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664
  • , Nozomu AsukaiAffiliated withDepartment of Social Psychiatry, Tokyo Institute of Psychiatry, 2-1-8 Kamikitazawa, Setagaya-ku, Tokyo, Japan
    • , Yosuke YonezawaAffiliated withDepartment of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130, Japan Tel.: +81-3-3633-6151, Fax: +81-3-3634-5664

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Abstract

This study investigated varieties and incidence of abnormal physiological conditions in acute schizophrenic patients on emergency. Laboratory data obtained prior to treatment from patients, admitted on an emergency basis during an 18-month period, were evaluated retrospectively, as well as demographics and clinical characteristics. Of 259 male acute schizophrenic patients (ICD-10: F2), 6.9% revealed dehydration, a third had hypokalemia and leukocytosis, and two thirds showed elevated serum muscle enzymes. These percentages were statistically significant compared with those of outpatients. In addition, the former three of these conditions in the F2 group were as frequent as those in alcohol and/or psychoactive substance abusers (ICD-10: F1) on emergency admission, although elevated serum muscle enzymes in the F2 group was less frequent than that in the F1 group. In order to prevent these abnormal physiological conditions from worsening and becoming life-threatening, one fourth of the F2 group [dehydration, 6.9%, severe hypokalemia (< 3.0 mEq/l), 2.3%, and markedly elevated serum muscle enzymes (creatine phosphokinase > 1000 IU/l), 16.5%] required medical management such as fluid therapy and various types of monitoring. In cases of a behavioral emergency, laboratory screening and monitoring of urinary output were essential. Due to their lack of cooperation, case history, physical examination, and initial vital signs did not contribute to detection of their medical condition.

Key words Schizophrenia Emergency Dehydration Potassium Creatine phosphokinase