REFEEDING SYNDROME IN SCHIZOPHRENIA CASE REPORT

Introduction: Recent studies have shown growing concern for refeeding syndrome (RFS) among patients suffering from other medical conditions, although the exact incidence in this population is unknown. The phenomenon is also present among patients with mental health conditions characterised by poor feeding, poor appetite, catatonic features, and poor cognitive functioning. Generally, RFS occurs with the reintroduction of calories to severely malnourished patients. It becomes critical for clinicians to have a high incidence of suspicion for prompt diagnosis and appropriate management to keep them alive if the malnutrition does not take their lives. Case Presentation: We report a case of a 53-year-old man with an 8-year history of schizophrenia and a 3-month history of poor feeding. We admitted him because he refused to feed or drink for two weeks. As a result, he was severely malnourished, and we started refeeding while dealing with his psychotic symptoms. He gained about 2kg within a week of admission, but that was fraught with metabolic derangements, which included hypophosphatemia, hypomagnesaemia, and hypocalcaemia. We revised his diagnosis to RFS in schizophrenia and managed it as such. Conclusion: There are no agreed biomarkers for the diagnosis of Refeeding Syndrome, and the diagnosis is mainly clinical, supported by electrolyte deficiencies. Unfortunately, hypophosphatemia does not have readily available formulations for its correction, which can lead to neurological, cardiovascular, and other complications, including sudden death. Delay in diagnosis worsens the prognosis, and the intuitive desire to feed a starved patient zealously leads them to death.