Unexplained Coma and Sudden Death in Psychiatric Patients Due to Self-Induced Water Intoxication: Clinical Insights and Autopsy Findings From Two Fatal Cases.

Résumé

Self-induced water intoxication is a life-threatening condition caused by excessive water intake that surpasses renal excretion capacity, resulting in hypotonic hyponatremia. This acute imbalance leads to cerebral and pulmonary edema, neurological deterioration, and potentially fatal outcomes. Psychiatric disorders such as schizophrenia and postpartum psychosis are significant contributors, often driving these behaviors through unique psychopathological mechanisms exacerbated by inadequate patient supervision. This study presents two fatal cases. The first involves a 42-year-old woman with chronic schizophrenia and psychogenic polydipsia, whose condition progressed gradually, allowing partial therapeutic intervention. The second describes a 28-year-old woman with postpartum psychosis and compulsive water drinking linked to religious delusions, whose condition deteriorated rapidly, leading to cardiopulmonary arrest shortly after admission. Both cases highlight the connection between psychiatric disorders and severe hyponatremia (