A STUDY OF THE PROBLEM OF MALNUTRITION IN INSTITUTIONALIZED PSYCHOTIC PATIENTS
HARRY C SHARP M. D., and
CRAWFORD N. BAGANZ M. D.1
1 Veteras' Administration, Lyons, N. J.
A statistical survey of the problem of malnutrition in chronic psychotic patients reveals the fact that 49.9 per cent of all the patients in the hospital weighed less than the normal weight as outlined by the report of the Medico-Actuarial Mortality Investigation. Approximately 30 per cent were ten or more pounds under weight and 14.3 per cent were twenty or more pounds under weight. Almost 57 per cent of the patients were under weight when they were admitted to the hospital, and further, 38 per cent of these have lost weight since admission. Likewise, 13.6 per cent of the patients were under weight when they were admitted and have lost ten or more pounds since that time. This rather staggering amount of malnutrition is present in a hospital where the caloric value of the diet exceeds "basal diet plus 50 per cent" caloric requirement by 56 per cent. Under carefully controlled conditions a group of patients was given a high caloric diet with conditions so controlled as to assure the intake of at least 4500 calories. Despite the administration of this amount of food, a large number of these patients failed to gain, and the average gain was less than four pounds over a period of twenty weeks. A like group was given the same dietary intake and in addition 15 to 25 units of insulin twice a day. This group of patients underwent a gain averaging approximately 27 pounds in twenty weeks.
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It must further be noted that while 56.6 per cent of all patients were under weight at time of admission, 49.9 per cent were under weight at the time of this survey. Several of the patients who received insulin for the treatment of malnutrition had striking and unexpected improvements in their psychoses.
