Are Patients With Schizophrenia Insensitive to Pain? A Reconsideration of the Question

Bonnot, Olivier; Anderson, George M.; Cohen, Doron; Willer, Jean Claude; Tordjman, Sylvie

doi:10.1097/ajp.0b013e318192be97

Cited by 111 publications

(87 citation statements)

References 80 publications

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“…The tendency of reduction in headache frequency in this group of patients might be explained by the less sensitivity to pain (8). Previous studies reported that the loss of pain sensation and the reduction of pain sensitivity were present (9)(10)(11). Although results of studies investigating the reduction of the pain sensation in schizophrenia are not convincing, four different kind of study types have provided data to support this argument; a) Clinical case reports that determine the reduced or no pain sensation in patients with schizophrenia during different kinds of painful medical situations (ruptured appendix, perforated bowel, peritonitis, etc.…”

Section: Introductionmentioning

confidence: 98%

The evaluation of headache in patients with schizophrenia: a case-control study

Güveli¹,

Bahçeci²,

Kırbaş³

et al. 2014

Dusunen Adam

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Objective: The aim of this study is to explore the frequency and the types of headache in patients with schizophrenia and to compare it with the healthy control group.Method: A hundred and one patients and eighty nine healthy subjects were included in this case-control study. Socio-demographic data form, structured clinical interview for DSM disorders type 1 (SCID-1), Scale for the Assessment of the Negative Symptoms (SANS) and of the Positive Symptoms (SAPS) were applied. The subjects with headache were consulted to the neurology clinic.Results: The prevalence of headache in the patient group was 38.6% whereas the prevalence of headache in the control group was 37.1%. Tension type headache (TTH) was the most prominent type in both group (31.7% of patients, 18.0% of controls) and the presence of TTH in patients with schizophrenia was found statistically significant. Migraine type headache was detected in 2.0% of patients and 11.2% of controls. The ratio of headache was lesser in patients than in the controls.Conclusion: Schizophrenic patients have headache as much as the healthy subjects but they complain less about their headache than the controls do. Further studies with larger samples in patients with schizophrenia would present the importance of the issue and improve the quality of life in patients with schizophrenia contributing the analgesia.Key words: Headache, migraine, pain, psychiatric disorders, schizophrenia ÖZET Şizofrenli hastalarda baş ağrısının değerlendirilmesi: Vaka-kontrol çalışması Amaç: Bu çalışmada şizofrenli hastalarda sağlıklı kontrol grubu ile karşılaştırarak baş ağrısı sıklığı ve hangi tip baş ağrılarının olduğunun araştırılması amaçlandı.Yöntem: Çalışmaya 101 hasta ve 89 sağlıklı kontrol grubu alındı. Hastalara araştırmacılar tarafından hazırlanan, hastanın sosyo-demografik özelliklerinin, hastalığı ile ilgili bilgilerin ve baş ağrısı ile ilgili soruların yer aldığı sosyodemografik veri formu, DSM-IV eksen 1 tanı ölçütlerine göre hazırlanmış yapılandırılmış bir klinik görüşme formu olan SCID-1 ve Pozitif ve Negatif Belirtileri Değerlendirme Ölçeği uygulandı. Şu anda ya da geçmişte baş ağrısı olduğunu ifade eden hastalar baş ağrısının değerlendirilmesi amacıyla nöroloji polikliniğine yönlendirildi.Bulgular: Şizofrenli hasta grubunun %38.6'sı baş ağrısı tanımlarken, kontrol grubunda bu oran %37.1 olarak bulundu. Her iki grupta da en fazla gerilim tipi baş ağrısı (GTBA) görülmesine rağmen (hasta grubu=%31.7, kontrol grubu=%18) şizofreni grubunda GTBA kontrol grubundan anlamlı olarak daha fazla bulundu. Migren tipi baş ağrısı ise kontrol grubunun %11.2'sinde görülürken, hasta grubunun %2'sinde görülmekteydi. Şizofrenili hasta grubu kontrol grubuna göre baş ağrısı yakınmasını daha az dile getirmekteydi.Sonuç: Bu çalışmada şizofrenili hastaların normal popülasyon kadar baş ağrısına maruz kaldığı, baş ağrısı yakınmasını normal topluma göre daha az dile getirdikleri sonucu elde edilmiştir. Bu konuda yapılacak geniş örneklemli çalışmalar ve oluşturulacak tedavi protokolleri şizofrenili hastalar...

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Section: Introductionmentioning

confidence: 98%

The evaluation of headache in patients with schizophrenia: a case-control study

Güveli¹,

Bahçeci²,

Kırbaş³

et al. 2014

Dusunen Adam

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“…Whilst the review of Stubbs et al [49] was helpful, the reliance on pain data from self-report and lack of pain severity measures in most studies might have introduced bias and noise. For example, cognitive deficits may impede the ability of people with schizophrenia to recognise and communicate the presence of pain [7]. In addition, the investigation of the prevalence of pain in schizophrenia patients is further complicated by the fact that antipsychotic medications have analgesic properties [45].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, pooling data on physiological responses to pain may offer a unique insight that circumvents concerns regarding cognitive and communication deficits when recognising and reporting pain in schizophrenia [7].…”

Section: Introductionmentioning

confidence: 99%

Decreased pain sensitivity among people with schizophrenia

Stubbs

Thompson

Acaster³

et al. 2015

Pain

105

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Schizophrenia patients report reduced pain sensitivity in clinical studies, but experimental studies are required to establish pain sensitivity as a potential endophenotype. We conducted a systematic review of electronic databases from database inception until 15/04/2015, including experimental studies investigating pain among schizophrenia-spectrum disorder patients versus healthy controls.A random effect meta-analysis yielding Hedges' g ±95% confidence intervals (CIs) as the effect size measure (ES) was conducted. Primary outcome was a pooled composite of pain threshold, pain tolerance, and sensory threshold; secondary outcomes included these parameters individually, plus physiological pain response, and pain intensity/unpleasantness. Across 17 studies, schizophreniaspectrum disorder patients (n=387, age=30.7±6.9 years, female=31.9%, illness duration=7.0±5.7 years) were compared with controls (n=483, age=29.5±7.4 years, female=31.0%). Patients had elevated pain threshold/pain tolerance/sensory threshold versus controls (ES=0.493, 95% CI=0.145-0.839, p=0.005; studies=17). Results were similar in antipsychotic-free individuals (ES=0.599, 95% CI=0.291-0.907, p<0.0001; studies=8), with trend-level significance in antipsychotic-treated individuals (ES=0.428, p=0.085; studies=11 spectrum disorders. How this alteration links to other dimensions of schizophrenia and physical comorbidity-related help-seeking behaviour/morbidity/mortality requires further study. schizophrenia, pain, experimental pain, physical health, pain assessment, pain management 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 Dr. Correll has been a consultant and/or advisor to or has received honoraria from AbbVie, Actavis, Alkermes, Bristol-Myers Squibb, Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Janssen/J&J, Lundbeck, MedAvante, Medscape, Otsuka, Pfizer, ProPhase, Reviva, Roche, Sunovion , 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 Abstract Schizophrenia patients report reduced pain sensitivity in clinical studies, but experimental studies are required to establish pain sensitivity as a potential endophenotype. We conducted a systematic review of electronic databases from database inception until 15/04/2015, including experimental studies investigating pain among schizophrenia-spectrum disorder patients versus healthy controls. Key words:A random effect meta-analys...

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“…This observation has been made since the disease was diagnosed for the first time by Kraeplin, who reported lack of adaptative reactions to different types of injuries such as burns, pinpricks and others [2,19,20]. Also, there are other cases cited in literature that involve schizophrenic patients diagnosed with acute appendicitis or perforated bowel who did not declare any sort of pain [3,4,6] or complained of a mild or intermittent pain, but without the presence of hard abdomen [5,6].…”

Section: Pain and Schizophreniamentioning

confidence: 99%

Phytotherapeutical implications in pain perception - focusing on schizophrenia

Antioch¹,

Ciobîcă²,

Compaore³

et al. 2017

ijpm

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A b s t r a c tSc varying from abolition to lack of any kind of changes compared to normal controls and even hypersensitivity. In this way, the hypothesis of amending schizophrenia enhanced the importance of pain medication. But managing pain phenomenon in schizophrenia has large and unknown implications. Nevertheless, pharmacological interactions between the medications for these two entities are unknown and mos side option. ancient knowledge and current scientific pr To our best of knowledge, this is the first time when pain, plants and schizophrenia are discussed together. In this way, it seems that by replacing fully synthesized chemical products, the risk of side have curing effects on the psychotic activities in schizophrenia. Therefore, through this mini ethonopharmacological approaches in pain conditions in the context of schizop highlighted some cases of inappropriate usage of plants in traditional therapy.

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Are Patients With Schizophrenia Insensitive to Pain? A Reconsideration of the Question

Cited by 111 publications

References 80 publications

The evaluation of headache in patients with schizophrenia: a case-control study

The evaluation of headache in patients with schizophrenia: a case-control study

Decreased pain sensitivity among people with schizophrenia

Phytotherapeutical implications in pain perception - focusing on schizophrenia

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