Hyponatremia-induced change in mood mimicking late-onset bipolar disorder.

Gen Hosp Psychiatry. 2011 Jan-Feb;33(1):83.e5-7. Epub 2010 Oct 27.


McKnight RF, Hampson S.
Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Lane, OX3 7JX Oxford, UK.

Abstract
OBJECTIVE: Hyponatremia and bipolar disorder are rarely considered to have common features. This report describes a case of hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) presenting as late-onset bipolar disorder and discusses the evidence linking hyponatremia to mood disorders.

METHOD: Case report and review of published literature.

RESULTS: This case provides evidence that mood changes identical to those seen in bipolar disorder may be caused by hyponatremia at a variety of concentrations.

CONCLUSIONS: Further research is required to determine causes of SIADH in psychiatric patients with symptomatic hyponatremia and to elucidate the mechanism by which hyponatremia causes changes in mood. In older patients presenting with new-onset bipolar disorder, a physical etiology must always be excluded.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID: 21353139 [PubMed - in process]

Corticosteroid-Induced Psychotic and Mood Disorders

Psychosomatics 42:461-466, December 2001


© 2001 The Academy of Psychosomatic Medicine



Corticosteroid-Induced Psychotic and Mood Disorders

Diagnosis Defined by DSM-IV and Clinical Pictures

Ken Wada, M.D., Norihito Yamada, M.D., Toshiki Sato, M.D., Hiroshi Suzuki, M.D., Masahito Miki, M.D., Yomei Lee, M.D., Kazufumi Akiyama, M.D., and Shigetoshi Kuroda, M.D.

Received November 15, 2000; revised March 23, 2001; accepted March 12, 2001. From the Department of Neuropsychiatry, Okayama University Medical School 2-5-1, Shikata-cho, Okayama 700-8558, Japan, Department of Psychiatry, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima 730-8518, Japan. Address correspondence and reprint requests to Dr. Wada Department of Psychiatry, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima 730-8518, Japan. E-mail: kenwada@do3.enjoy.ne.jp

The authors investigated long-term outcome and treatment strategy of corticosteroid-induced psychotic and mood disorders as defined by DSM-IV. Review of medical records of 2,069 referral patients revealed 18 applicable patients. Their clinical characteristics, longitudinal courses, and treatments were studied. The authors identified 15 patients with mood disorder and 3 patients with psychotic disorder. Increasing doses or resumption of corticosteroids had the strongest influence on the psychiatric course. These two corticosteroid-induced psychiatric disorders may have different pathophysiological substrates closely related to patient vulnerability. Effective psychopharmacological treatment options were indicated with consideration being given to the underlying diseases.


Key Words: Cortiscosteroid • Mood Disorder • Psychotic Disorder