The 130th Annual Meeting of APHA

Abstract #40894

Deborah L. May, DNS, RN, CS, Psychiatric/Mental Health Nursing, Indiana University School of Nursing - East, 2325 Chester Blvd, 205 Hayes Hall, Richmond, IN 47374, 317-733-8508, dlmay1@indiana.edu

Self-induced water intoxication (SIWI) has been documented in individuals with severe mental illness in long-term psychiatric hospitals. With the return of the mentally ill to the community there was a need to determine fluid drinking patterns of the mentally ill outside of long-term hospitalization. The sample consisted of 30 individuals (Caucasian N=24, African American N=6) with a history of excess fluid drinking. Analysis included descriptive statistics and repeated analysis of variance.

Urine specific gravity (USG) measures, obtained in the AM and PM over a four week period, revealed a PM mean score of 1.003 (extent of fluid loading), and was indicative of SIWI at a level associated with seizure risk. The mean morning USG was lower than normal at 1.008. Diurnal variation, defined as the difference between the AM and PM USG levels, is usually varied in SIWI. Little variation was found in this study because of the low AM USG and suggests that the individuals drank excess fluids throughout the night and remained in a continuous state of excess fluid intake.

The pattern of continuous excess fluid load suggests that community residing mentally ill individuals with SIWI may be especially at risk to develop chronic health problems of congestive heart failure, hypertension, and chronic kidney which are focus areas of the Healthy People 2010 objectives. Implications for nursing include early awareness and treatment of SIWI in this vulnerable population of community-residing mentally ill.

Learning Objectives:

• Identify patterns of fluid drinking in community residing mentally ill individuals that make them vulnerable for acute and chronic health problems.
• Articulate the procedure for assessing self-induced water intoxication in community residing chronically mentally ill.

Keywords: Adult and Child Mental Health, Chronic Diseases

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.