A demographic study of polydipsia in an institution for the intellectually disabled

Guidelines for the use of clozapine in individuals with developmental disabilities

Clozapine is the most effective antipsychotic medication currently in use, but there has been a paucity of well-controlled research on its efficacy with people with developmental disabilities. We present a set of guidelines to ensure proper utilization of clozapine in individuals with developmental disabilities, because it can offer them therapeutic advantages similar to those observed in people with schizophrenia. We provide recommendations regarding the use of clozapine that are based on three main sources: literature and published professional practice guidelines regarding the use of clozapine in individuals who do not have developmental disabilities, the limited literature on the use of clozapine in individuals who have developmental disabilities, and our own clinical experience. The first part of the guidelines contains an overview of necessary practical knowledge regarding side effects, dose and blood level considerations, and interactions with other medications, diet and tobacco smoking. In the second part, we offer procedures for selecting individuals for clozapine therapy based on proper indications and contraindications for treatment. We also include requirements regarding informed consent, dosage and special laboratory and clinical monitoring.

Polydipsia screening tool

Polydipsia is a condition whereby individuals consume excessive amounts of liquids, which is common in patients with schizophrenia. A 17-item Polydipsia Screening Tool (PST; Copyright 2000 by Sheila Reynolds) was evaluated for psychometric properties. Five nurses and 70 psychiatric residents in a 92-bed nursing home comprised the samples. The interrater reliability (mean intraclass correlation coefficient) was 0.84. The average test-retest agreement was 92.4% with agreement ranging from 75% to 100%. Internal consistency of the tool was 0.79. Sensitivity and specificity were 80% and 68%, respectively. Additionally, validity of the PST was supported using a medical record history of polydipsia, low serum sodium, and low specific gravity.

Identifying at risk nursing home residents using a polydipsia screening tool

Persons diagnosed with schizophrenia are considered at risk for polydipsia, a potentially life-threatening condition characterized by excessive consumption of fluids. This study examined the demographic and health-related characteristics of nursing home residents with psychiatric diagnoses (N = 70) who reside in a 92-bed facility. The prevalence of polydipsia and behavioral characteristics and symptoms as measured by a 17-item polydipsia screening tool also were described. Patients who screened positive for polydipsia (36%) exhibited behaviors that included incontinence, smoking, frequent voiding, and preference for fluid over food. A polydipsia screening program could minimize morbidity and mortality associated with this fairly prevalent condition.