64-Year-Old Male with Undifferentiated Schizophrenia, Lengthy Institutionalization, Water Imbalance

Richard C. Josiassen
Jessica Curtis
Dawn Filmyer
Alexander Geboy
Rita A Shaughnessy


The patient is an unmarried, unemployed, white male with chronic, undifferentiated schizophrenia, who at age 64 years was discharged from a state hospital into a community assisted-living program. Although being discharged into the community is unremarkable, two facts make this patient’s discharge noteworthy. First, he had been hospitalized continuously in this single institution for almost half a century since the age of 16 years. Second, the major obstacle to his discharge was not the severity of his psychosis, but the lack of optimal treatment options for his chronic and potentially life-threatening hyponatremia.