Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T16:45:09.183Z Has data issue: false hasContentIssue false

Relationships Between Pain and Schizophrenia

Published online by Cambridge University Press:  29 January 2018

G. D. Watson
Affiliation:
Department of Psychiatry, University of Alberta, Edmonton, Alberta, T6G 2G3
P. C. Chandarana
Affiliation:
University of Western Ontario, Victoria Hospital, London, Ontario
H. Merskey
Affiliation:
University of Western Ontario, London Psychiatric Hospital, London, Ontario

Summary

In an examination of the phenomenology of pain in 78 patients with schizophrenia, 29 had current pain complaints. Of these 13 had an appropriate physical cause, leaving 16 with pain of seemingly psychological origin. The head, leg and back were the commonest sites. Complaints were most often described in sensory terms.

Pain plausibly related to a specific delusion or hallucinatory process occurred only once, and no gross examples of insensitivity to noxious stimuli or to self-mutiliation were seen. Patients with schizophrenia may have less pain than those with anxiety or depression but certainly do experience pain both from physical and psychological causes. The influence of phenothiazines on pain experience is uncertain.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bleuler, E. (1911) Textbook of Psychiatry (transl. 1951 by Brill, H. A.). New York: Dover Publications.Google Scholar
Boyd, D. B. & Merskey, H. (1978) A note on the description of pain and its causes. Pain, 5, 13.Google Scholar
Brown, F. (1936) The bodily complaint: a study of hypochondriasis. Journal of Mental Science, 82, 295.CrossRefGoogle Scholar
Chapman, K. (1966) The early symptoms of schizophrenia. British Journal of Psychiatry, 112, 225251.CrossRefGoogle ScholarPubMed
Delaplaine, R. Ifabumuyi, O. I. & Merskey, H. (1978) Significance of pain in psychiatric hospital patients. Pain, 4, 361366.Google Scholar
Engel, G. (1959) ‘Psychogenic’ pain and the pain-prone patient. American Journal of Medicine, 899917.Google Scholar
Geschwind, N. (1977) Insensitivity to pain in psychotic patients. New England Journal of Medicine, 296, 1480.Google Scholar
Gittleson, N. L. (1961) Psychiatric headache: a clinical study. Journal of Mental Science, 107, 403.Google Scholar
Hall, K. R. L. & Stride, E. (1954) The varying response to pain in psychiatric disorders: a study in abnormal psychology. British Journal of Medical Psychology, 27, 4860.Google Scholar
Horrobin, D. F. Ally, A. I. & Karmali, R. A. (1978) Prostaglandins and schizophrenia: a further discussion of the evidence. Psychological Medicine, 8, 4348.CrossRefGoogle ScholarPubMed
Marchand, W. E. Sarota, B. & Marble, H. C. (1959) Occurrence of painless acute surgical disorders in psychotic patients. New England Journal of Medicine, 260, 580.Google Scholar
May, P. R. A. (1948) Pupillary abnormalities in schizophrenia and during muscular effort. Journal of Mental Science, 94, 8998.Google Scholar
Mayer-Gross, W. (1938) The early diagnosis of schizophrenia. British Medical Journal, ii, 936939.CrossRefGoogle Scholar
Melzack, R. & Torgerson, W. S. (1971) On the language of pain. Anaesthesiology, 34, 5059.Google Scholar
Melzack, R. (1975) The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277299.Google Scholar
Merskey, H. (1964) An investigation of pain. D.M. Thesis in Psychological Illness. Oxford.Google Scholar
Merskey, H. (1965) Psychiatric patients with persistent pain. Journal of Psychosomatic Research, 9, 299309.Google Scholar
Merskey, H. Gillis, A. & Marzalek, K. S. (1962) A clinical investigation of reactions to pain. Journal of Mental Science, 108, 347355.CrossRefGoogle ScholarPubMed
Merskey, H. & Hester, R. N. (1972) The treatment of chronic pain with psychotropic drugs. Postgraduate Medical Journal, 48, 594.CrossRefGoogle ScholarPubMed
Merskey, H. & Spear, F. G. (1967) Pain—psychological and psychiatric aspects. In Pain. London: Bailliere, Tindall & Cassell.Google Scholar
Schneider, K. (1959) Clinical Psychopathology. (Transl. by Hamilton, M.). Pp 85. New York: Grune & Stratton.Google Scholar
Snyder, S. (1976) Butyrephenone influences on the opiate receptor. European Journal of Pharmacology, 36, 231235.Google Scholar
Spear, F. G. (1964) A study of pain as a symptom of psychological illness. M.D. Thesis. Bristol.Google Scholar
Spear, F. G. (1967) Pain in psychiatric patients. Journal of Psychosomatic Research, ii, 187193.Google Scholar
Taub, A. & Collins, W. (1974) Observations on the treatment of denervation dysesthesias with psychotropic drugs: postherpetic neuralgias, anaesthesia adorosa, peripheral neuropathy. Advances in Neurology (ed. Bonica, J.). Vol. 4, pp 309. New York: Raven Press.Google Scholar
Terenius, L. & Wahlstrom, A. (1978) Physiologic and clinical relevance of endorphins. Centrally Acting Peptides (ed. Hughes, J.), pp 161178. Baltimore University Park Press.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.