Psychopathological characteristics in patients with arginine vasopressin deficiency (central diabetes insipidus) and primary polydipsia compared to healthy controls.

OBJECTIVE: Distinguishing arginine vasopressin deficiency (AVP-D; central diabetes insipidus) from primary polydipsia (PP), commonly referred to as psychogenic polydipsia, is challenging. Psychopathologic findings, commonly used for PP diagnosis in clinical practice, are rarely evaluated in AVP-D patients, and no comparative data between the two conditions currently exist. DESIGN: Data from two studies involving 82 participants [39 AVP-D, 28 PP, and 15 healthy controls (HC)]. METHODS: Psychological evaluations were conducted using standardized questionnaires measuring anxiety [State-Trait Anxiety Inventory (STAI)], alexithymia [Toronto Alexithymia Scale (TAS-20)], depressive symptoms (Beck's Depression Inventory-II (BDI-II), and overall mental health [Short Form-36 Health Survey (SF-36)]. Higher STAI, TAS-20, and BDI-II scores suggest elevated anxiety, alexithymia, and depression, while higher SF-36 scores signify better overall mental health. RESULTS: Compared to HC, patients with AVP-D and PP showed higher levels of anxiety (HC 28 points [24-31] vs AVP-D 36 points [31-45]; vs PP 38 points [33-46], P < .01), alexithymia (HC 30 points [29-37] vs AVP-D 43 points [35-54]; vs PP 46 points [37-55], P < .01), and depression (HC 1 point [0-2] vs AVP-D 7 points [4-14]; vs PP 7 points [3-13], P < .01). Levels of anxiety, alexithymia, and depression showed no difference between both patient groups (P = .58, P = .90, P = .50, respectively). Compared to HC, patients with AVP-D and PP reported similarly reduced self-reported overall mental health scores (HC 84 [68-88] vs AVP-D 60 [52-80], P = .05; vs PP 60 [47-74], P < .01). CONCLUSION: This study reveals heightened anxiety, alexithymia, depression, and diminished overall mental health in patients with AVP-D and PP. The results emphasize the need for careful interpretation of psychopathological characteristics to differentiate between AVP-D and PP.

Differential Neurobiological Markers in Phenotype-stratified Rats Modeling High or Low Vulnerability to Compulsive Behavior: A Narrative Review.

Compulsivity is a key manifestation of inhibitory control deficit and a cardinal symptom in different neuropsychopathological disorders such as obsessive-compulsive disorder, schizophrenia, addiction, and attention-deficit hyperactivity disorder. Schedule-induced polydipsia (SIP), is an animal model to study compulsivity. In this procedure, rodents develop excessive and persistent drinking behavior under different food-reinforcement schedules, that are not related to homeostatic or regulatory requirements. However, there are important individual differences that support the role of high-drinker HD rats as a compulsive phenotype, characterized in different paradigms by inhibitory response deficit, cognitive inflexibility, and resistant to extinction behavior; with significant differences in response to pharmacological challenges, and relevant neurobiological alterations in comparison with the control group, the non-compulsive low drinker LD group on SIP. The purpose of this review is to collate and update the main findings on the neurobiological bases of compulsivity using the SIP model. Specifically, we reviewed preclinical studies on SIP, that have assessed the effects of serotonergic, dopaminergic, and glutamatergic drugs; leading to the description of the neurobiological markers, such as the key role of the serotonin 5-HT2A receptor and glutamatergic signaling in a phenotype vulnerable to compulsivity as high drinker HD rats selected by SIP. The review of the main findings of HD rats on SIP helps in the characterization of the preclinical compulsive phenotype, disentangles the underlying neurobiological, and points toward genetic hallmarks concerning the vulnerability to compulsivity.

Socioemotional deficit and HPA axis time response in high compulsive rats selected by schedule-induced polydipsia.

Compulsivity is a failure to stop an ongoing behavior that has become inappropriate to the situation and is recognized as a transdiagnostic trait present in different neuropsychiatric disorders. The implication of motivation and emotion, as well as the stress response in compulsive population has not been fully understood. We assessed the motivation to reward and cues, the emotional response in different contexts and the hypothalamic-pituitary-adrenal (HPA) axis response in rats selected by a preclinical model of compulsive behavior. Firstly, high (HD) or low (LD) drinkers were selected according to their drinking behavior on schedule-induced polydipsia (SIP). Then, we assessed motivation by the propensity to attribute incentive salience to rewards on Pavlovian Conditioned Approach (PavCA) and motivation to gain reward on Progressive Ratio Schedule of Reinforcement (PRSR). Emotion was measured by Social Dominance on the Tube Test (SDTT) and emotional memory on Passive Avoidance (PA). Plasma corticosterone (CORT) levels in response to SIP were assessed. HD rats showed a socioemotional deficit by fewer victories on the SDTT, and an increased latency to enter the dark compartment on the PA. No differences were found between groups regarding to motivational assessment. Moreover, HD rats revealed a blunted time response in the increase of CORT levels at 45 min after SIP compared to LD rats. The findings show that the compulsive phenotype of HD rats exhibit less social dominance, more resistance to extinction and a differential CORT time response to SIP. These findings may contribute to highlight the relevance of assessing socioemotional behaviors and stress response for a better characterization of the vulnerability to compulsive spectrum disorders.

Of Mice and Men-The Physiology, Psychology, and Pathology of Overhydration.

The detrimental effects of dehydration, to both mental and physical health, are well-described. The potential adverse consequences of overhydration, however, are less understood. The difficulty for most humans to routinely ingest ≥2 liters (L)-or "eight glasses"-of water per day highlights the likely presence of an inhibitory neural circuit which limits the deleterious consequences of overdrinking in mammals but can be consciously overridden in humans. This review summarizes the existing data obtained from both animal (mostly rodent) and human studies regarding the physiology, psychology, and pathology of overhydration. The physiology section will highlight the molecular strength and significance of aquaporin-2 (AQP2) water channel downregulation, in response to chronic anti-diuretic hormone suppression. Absence of the anti-diuretic hormone, arginine vasopressin (AVP), facilitates copious free water urinary excretion (polyuria) in equal volumes to polydipsia to maintain plasma tonicity within normal physiological limits. The psychology section will highlight reasons why humans and rodents may volitionally overdrink, likely in response to anxiety or social isolation whereas polydipsia triggers mesolimbic reward pathways. Lastly, the potential acute (water intoxication) and chronic (urinary bladder distension, ureter dilation and hydronephrosis) pathologies associated with overhydration will be examined largely from the perspective of human case reports and early animal trials.

Behavioral and biological markers for predicting compulsive-like drinking in schedule-induced polydipsia.

Schedule-induced polydipsia (SIP), characterized by the development of persistent and excessive drinking under intermittent food-reinforcement schedules, is an animal model of compulsive behavior that can differentiate two populations: high drinkers (HD) and low drinkers (LD). The aim of the present study was to identify behavioral and biological markers to predict the vulnerability to developing compulsive-like drinking in SIP. Adult male Wistar rats were first trained in a spatial-discrimination serial reversal-learning task and in a reinforcer devaluation task to measure behavioral flexibility and habit formation, respectively. Subsequently, the rats were tested using the SIP protocol and identified as HD or LD based on their drinking rates. The performance of HD and LD rats in the two previous tasks was then analyzed. Before and after SIP exposure, blood glucose and plasma corticosterone (CORT) levels were measured. Additionally, serum electrolyte levels, including sodium, potassium, and chloride, were analyzed after SIP. HD rats showed higher behavioral inflexibility by exhibiting increased perseverative responses in the reversal-learning task and insensitivity to reinforcer devaluation during extinction under selective satiation. After SIP exposure, HD rats exhibited increased basal plasma CORT levels, indicating that this vulnerable group might have a dysregulation of the HPA axis. Although HD and LD rats had blood glucose levels within normal range, the HD group showed lower levels. The HD group did not exhibit hyponatremia (i.e., reduced serum sodium levels) when compared to LD rats after 20 daily SIP sessions. The results of the present study demonstrated that HD rats exhibit behavioral inflexibility and greater habitual-like behavior before SIP. Moreover, these results highlight the importance of measuring different behavioral and biological markers for predicting the vulnerability to developing compulsivity, and for enhancing the understanding of the pathophysiology of compulsive spectrum disorders.

Paternal preconception ethanol exposure blunts hypothalamic-pituitary-adrenal axis responsivity and stress-induced excessive fluid intake in male mice.

A growing number of environmental insults have been shown to induce epigenetic effects that persist across generations. For instance, paternal preconception exposures to ethanol or stress have independently been shown to exert such intergenerational effects. Since ethanol exposure is a physiological stressor that activates the hypothalamic-pituitary-adrenal (HPA) axis, we hypothesized that paternal ethanol exposure would impact stress responsivity of offspring. Adult male mice were exposed to chronic intermittent vapor ethanol or control conditions for 5 weeks before being mated with ethanol-naïve females to produce ethanol (E)- and control (C)-sired offspring. Adult male and female offspring were tested for plasma corticosterone (CORT) levels following acute restraint stress and the male offspring were further examined for stress-evoked 2-bottle choice ethanol-drinking. Paternal ethanol exposure blunted plasma CORT levels following acute restraint stress selectively in male offspring; females were unaffected. In a stress-evoked ethanol-drinking assay, there was no effect of stress on ethanol consumption. However, C-sired males exhibited increased total fluid intake (polydipsia) in response to stress while E-sired males were resistant to this stress-induced phenotype. Taken together, these data suggest that paternal ethanol exposure imparts stress hyporesponsivity to male offspring.

Recurrent rhabdomyolysis in a teenager with psychosis-intermittent hyponatremia-polydipsia syndrome.

OBJECTIVE: To report a case of recurrent hyponatremia and rhabdomyolysis in a teenager with psychogenic polydipsia. CASE SUMMARY: A 16-year-old boy was admitted with recurrent episodes of hyponatremia and rhabdomyolysis secondary to psychogenic polydipsia. He was treated with hypertonic saline, intravenous fluids, and supportive care. DISCUSSION: Psychogenic polydipsia is a condition characterized by compulsive drinking. Severe hyponatremia is a rare, but serious complication in patients with psychogenic polydipsia. Failure in cell volume regulatory mechanisms, defective osmoregulation, defective urinary dilution, and enhanced secretion of vasopressin are believed to play a role in the development of hyponatremia. Rhabdomyolysis can complicate severe hyponatremia, although the exact mechanism is not known. Antipsychotic drugs are also implicated in rhabdomyolysis. CONCLUSIONS: Severe hyponatremia and rhabdomyolysis can complicate psychogenic polydipsia. Patients receiving antipsychotic drugs with concomitant severe hyponatremia need to be monitored for rhabdomyolysis.

Context specificity of extinguished schedule-induced drinking within an ABA renewal design in rats / Especificidad contextual de la extinción de la bebida inducida por programa en un diseño de renovación ABA en ratas

The main goal of this study was to explore whether extinction of schedule-induced adjunctive drinking (polydipsia) may become under contextual control. Drinking was induced by a Fixed-Time 30 sec food delivery schedule (FT30). Experiment 1 used a 2 x 2 factorial design with Schedule (FT30 vs. food a the start of the session), and Stimulus (Presenceor absence of a 10 sec tone at the end of each 30 sec period within a session) as factors. Acquisition and extinction were conducted in two different contexts, returning to the acquisition context at testing. Experiment 2 tested contextual control of extinction against a control that remained in the extinction context at testing. Recovery from extinction was observed as an increase in water intake (as well as in magazine entries) during the test, regardless of the presence of the tone. Implications for theunderstanding of schedule-induced drinking as a conditioned response are discusse (AU)

El objetivo principal de este estudio fue evaluar si la extinción de la bebida adjuntiva inducida por programa (polidipsia) podía quedar bajo control contextual. La bebida se indujo mediante un programa de administración de comida de tiempo fijo 30 segundos (TF30). El experimento 1 utilizó un diseño factorial 2 x 2 con Programa (TF30 vs. comida al inicio de la sesión) y Estímulo (presencia o ausencia de un sonido de 10s al final de cada periodo de 30s dentro de la sesión)como factores. La adquisición y la extinción se realizaron en contextos diferentes, regresando al contexto de adquisición durante la prueba. El experimento 2 introdujo una condición de control que recibió la prueba en el contexto de extinción. La recuperación de la extinción se observó como un aumento en la ingesta de agua (así como en las entradas en el comedero) durante la prueba, independientemente de la presencia del sonido. Se discuten las implicaciones de estos resultados para la interpretación de la bebida inducida por programa como una respuesta condicionada (AU)

Different relations between schedule-induced polydipsia and impulsive behaviour in the Spontaneously Hypertensive Rat and in high impulsive Wistar rats: questioning the role of impulsivity in adjunctive behaviour.

Rats belonging to three different strains (15 Wistar, 8 Spontaneously Hypertensive - SHR- and 8 Wistar Kyoto - WKY-) were used to evaluate the possible relationship between different levels of impulsivity and development of schedule-induced polydipsia (SIP). We first measured the rats' levels of impulsivity by means of delay-discounting and indifference-point procedures. Secondly, development of SIP was studied under a series of fixed time 15, 30, 60 and 120s food schedules, which were counterbalanced by means of a Latin-square design. Finally, we re-assessed the rats' levels of impulsivity by replicating the delay-discounting test. The findings showed that, starting from equivalent levels of impulsivity, development of SIP differed among the groups of rats. In comparison with the rest of the animals, the SHRs were observed to attain elevated drinking rates under SIP. On the other hand, the Wistar rats which had initial high impulsivity levels similar to those of the SHRs, displayed the lowest rates of induced drinking. Moreover, low levels of impulsivity in Wistar rats prior to SIP acquisition were reflected into high drinking rates. Relation of SIP and impulsivity is questioned by present results, which gives ground to the understanding of the behavioural mechanisms involved in adjunctive behaviour and its usefulness as an animal model of excessive behaviour.

Subchronic and mild social defeat stress accelerates food intake and body weight gain with polydipsia-like features in mice.

Development and characterization of animal models of depression are essential for fully understanding the pathogenesis of depression in humans. We made and analyzed a mouse model exhibiting social deficit and hyperphagia-like behavior using a subchronic and mild social defeat stress (sCSDS) paradigm. The body weight, food and water intake of mice were monitored during a test period, and their behaviors and serum components were analyzed at two stages: immediately after the sCSDS period and 1 month after the sCSDS. The body weight and food intake of defeated mice were significantly higher than control mice at the sCSDS period, and these differences were sustained until 1 month after the sCSDS, whereas the water intake of defeated mice was significantly higher than control mice for the period of sCSDS only. Behavioral analyses revealed that the defeated mice exhibit significant social aversion to unfamiliar mice in a social interaction test and a trend of anxiety-like behavior in an elevated-plus maze test. Possibly due to polydipsia-like symptoms, defeated mice had significantly lower levels of albumin and blood urea nitrogen than control mice immediately after the sCSDS period but not at 1 month after sCSDS. The present study revealed that our sCSDS mice keep much more water in their body than control mice. This study reports the first step toward an understanding of the mechanisms of stress-induced overhydration, over-eating and resultant weight gain.

Poor inhibitory control and neurochemical differences in high compulsive drinker rats selected by schedule-induced polydipsia.

RATIONALE: Schedule-induced polydipsia (SIP), characterized by the development of excessive drinking under intermittent food reinforcement schedules, has been proposed as a model for obsessive-compulsive disorder, schizophrenia and drug abuse. OBJECTIVES: The purpose of this study is to investigate if individual differences in SIP reflect psychopathological behavioural traits related to lack of inhibitory control and reactivity to novelty, and if these differences have neurochemical correlates. METHODS: Outbred Wistar rats were selected for being either high (HD) or low (LD) drinkers according to their SIP behaviour. We tested locomotor reactivity to a novel environment and inhibitory control on the five-choice serial reaction time task (5-CSRTT), under baseline vs. extinction conditions and following challenge with D: -amphetamine (saline, 0.5 or 1 mg/kg). Post-mortem analyses of the monoaminergic levels in different brain regions were also analysed. RESULTS: Compared to LD animals, HD rats exhibiting SIP acquisition showed no differences in spontaneous locomotor reactivity to novelty. On the 5-CSRTT, HD rats showed a greater increase in perseverative responses under extinction, a trend towards elevated premature responses on baseline, and a significantly greater elevation of premature responses to D: -amphetamine 0.5 mg/kg. The HD animals also exhibited increased serotonin activity in the amygdala, and correlational analyses between the rate of drinking on SIP and monoamine levels also revealed altered dopaminergic mesolimbic function. CONCLUSIONS: These findings show that HD rats selected by SIP exhibit compulsive and impulsive behaviour based on measures of performance on the five-choice serial reaction time task and associated with changes in monoaminergic systems in limbic-striatal circuitry.

Schedule-induced polydipsia as a model of compulsive behavior: neuropharmacological and neuroendocrine bases.

BACKGROUND: Schedule-induced polydipsia (SIP), characterized by the development of excessive drinking under intermittent food-reinforcement schedules, has been proposed as a successful model for obsessive-compulsive disorder (OCD), schizophrenia, and alcohol abuse. OBJECTIVES: The purpose of this study was to review the main findings and current thinking regarding the use of SIP for compulsivity assessment and evaluate its contribution to improving our knowledge of the neurobehavioral mechanisms underlying the excessive behavior manifested in SIP relevant to compulsive behavior disorders. METHODS: The literature reviews SIP procedure and surveys main findings about its neurobehavioral basis and pharmacology relevant to its possible status as a model for compulsive disorders. Specifically, we reviewed effects of antipsychotics and serotoninergic drugs used in the treatment of OCD and schizophrenia. We also considered individual differences in SIP and its relevance as a possible compulsivity endophenotype. CONCLUSIONS: SIP represents an animal model of non-regulatory and excessive drinking that may be valid for studying the psychopharmacology of the compulsive phenotype and modeling different psychopathologies from compulsivity spectrum disorders.