A potential case of refeeding syndrome in a patient with severe mental illness

Refeeding syndrome (RFS) occurs when previously malnourished patients are reintroduced to nutritional support, triggering a metabolic response that often results in electrolyte abnormalities, vitamin deficiencies, and potential end organ disturbance. Whereas RFS has been well documented in patients with eating disorders, its presentation in those with severe mental illness (SMI), such as schizophrenia, is less commonly reported. This report highlights a case of schizophrenia-induced starvation and the potential development of RFS during an inpatient psychiatric hospitalization. RFS may not always be identified in patients, especially when its presentation deviates from classic signs and symptoms. Increased awareness of the signs, symptoms, and at-risk populations, including individuals with SMI, may aid in the prevention and management of RFS.