title: Abnormal physiological conditions in acute schizophrenic patients on emergency admission: dehydration, hypokalemia, leukocytosis and elevated serum muscle enzymes.
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.
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Bokuto General Hospital, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hatta
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Yamashiro
authors.forename: H
authors.initials: H
authors.lastname: Endo
authors.forename: S
authors.initials: S
authors.lastname: Fujii
authors.forename: G
authors.initials: G
authors.lastname: Fukami
authors.forename: K
authors.initials: K
authors.lastname: Masui
authors.forename: N
authors.initials: N
authors.lastname: Asukai
authors.forename: Y
authors.initials: Y
authors.lastname: Yonezawa
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001806:Blood Urea Nitrogen; D002648:Child; D003402:Creatine Kinase / Q000378:metabolism; D003681:Dehydration / Q000150:complications / Q000503:physiopathology; D004632:Emergency Medical Services; D004637:Emergency Services, Psychiatric; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000150:complications / Q000503:physiopathology; D007958:Leukocyte Count; D007964:Leukocytosis / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000201:enzymology*; D012559:Schizophrenia / Q000097:blood / Q000201:enzymology / Q000503:physiopathology*
chemical_list: D003402:Creatine Kinase