Psychiatric reactions to long-term intravenous hyperalimentation

The authors reviewed charts of 100 patients receiving total parenteral nutrition (TPN) and 100 control patients with similar diagnoses who did not receive TPN. In addition, 30 patients were studied with a structured interview and a psychiatric questionnaire. Organic brain syndromes and other confusional states were no more common in the patients on TPN than in the controls, and hyperalimentation did not appear to be a determining factor in the onset of psychosis or depression. Two dangers of TPN, apparently unreported previously, were noted. First, the use of hyperalimentation as primary treatment for anorexia nervosa (rather than as an adjunct to psychiatric therapy) can have serious consequences, such as cerebellar degeneration and suicidal ideation. Second, psychiatric disturbances in caretakers can endanger patients’ lives.