Abstract
Results from several studies suggest that pain experience is diminished in people with schizophrenia. A reduced sensitivity for pain would have implications for treating people for painful conditions in clinical practice. In this chapter, a short overview of pain in schizophrenia is provided along with discussion of some theoretical suggestions concerning the neuropathology of schizophrenia in pain-processing areas. Additionally, we mention possible confounders for pain research in persons with schizophrenia.
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References
Almeida JG, Kurita GP, Braga PE, Pimenta CA (2010) Chronic pain in schizophrenic patients: prevalence and characteristics. Cad Saude Publica 26(3):591–602, doi:S0102-311X2010000300016 [pii]
Atik L, Konuk N, Akay O, Ozturk D, Erdogan A (2007) Pain perception in patients with bipolar disorder and schizophrenia. Acta Neuropsychiatr 19(5):284–290
Bair MJ, Robinson RL, Katon W, Kroenke K (2003) Depression and pain comorbidity: a literature review. Arch Intern Med 163(20):2433
Bär KJ, Brehm S, Boettger MK, Boettger S, Wagner G, Sauer H (2005) Pain perception in major depression depends on pain modality. Pain 117(1–2):97–103
Bassett DS, Bullmore E, Verchinski BA, Mattay VS, Weinberger DR, Meyer-Lindenberg A (2008) Hierarchical organization of human cortical networks in health and schizophrenia. J Neurosci 28(37):9239–9248
Benedetti F, Vighetti S, Ricco C, Lagna E, Bergamasco B, Pinessi L, Rainero I (1999) Pain threshold and tolerance in Alzheimer’s disease. Pain 80(1–2):377–382
Bloch Y, Mendlovic S, Strupinsky S, Altshuler A, Fennig S, Ratzoni G (2001) Injections of depot antipsychotic medications in patients suffering from schizophrenia: do they hurt? J Clin Psychiatry 62(11):855–859
Blumensohn R, Ringler D, Eli I (2002) Pain perception in patients with schizophrenia. J Nerv Ment Dis 190(7):481–483
Bonnot O, Anderson GM, Cohen D, Willer JC, Tordjman S (2009) Are patients with schizophrenia insensitive to pain? A reconsideration of the question. Clin J Pain 25(3):244–252
Brown ST, Kirkpatrick MK, Swanson MS, McKenzie IL (2010) Pain experience of the elderly. Pain Manag Nurs 12:190–196
Cole MW, Anticevic A, Repovs G, Barch D (2011) Variable global dysconnectivity and individual differences in schizophrenia. Biol Psychiatry 70:43–50
Collins L, Stone LA (1966) Pain sensitivity, age and activity level in chronic schizophrenics and in normals. Br J Psychiatry 112(482):33–35
de la Fuente-Sandoval C, Favila R, Gomez-Martin D, Pellicer F, Graff-Guerrero A (2010) Functional magnetic resonance imaging response to experimental pain in drug-free patients with schizophrenia. Psychiatry Res 183(2):99–104
de la Fuente-Sandoval C, Favila R, Gomez-Martin D, Leon-Ortiz P, Graff-Guerrero A (2011) Neural response to experimental heat pain in stable patients with schizophrenia. J Psychiatr Res 46(1):128–134
Dworkin RH, Clark W, Lipsitz JD, Amador XF et al (1993) Affective deficits and pain insensitivity in schizophrenia. Motiv Emot 17(3):245–276
El-Mallakh RS, Garver D, Holcomb JA, Wyatt RJ (2005) Post lumbar-puncture headaches in schizophrenic and psychiatrically normal control subjects. Schizophr Res 77(1):111–112
Engels G, Francke AL, van Meijel B, Douma JG, de Kam H, Wesselink W, Scherder EJ (2014) Clinical Pain in Schizophrenia: A Systematic Review. The Journal of Pain 15(5):457–467
Fornito A, Yücel M, Dean B, Wood SJ, Pantelis C (2009) Anatomical abnormalities of the anterior cingulate cortex in schizophrenia: bridging the gap between neuroimaging and neuropathology. Schizophrenia bulletin 35(5):973–993
Gibson SJ, Farrell M (2004) A review of age differences in the neurophysiology of nociception and the perceptual experience of pain. Clin J Pain 20(4):227
Girard M, Plansont B, Bonnabau H, Malauzat D (2011) Experimental pain hypersensitivity in schizophrenic patients. Clin J Pain 27(9):790–795
Guieu R, Samuelian JC, Coulouvrat H (1994) Objective evaluation of pain perception in patients with schizophrenia. Br J Psychiatry 164(2):253–255
Gur RE, Maany V, Mozley PD, Swanson C, Bilker W, Gur RC (1998) Subcortical MRI volumes in neuroleptic-naive and treated patients with schizophrenia. Am J Psychiatry 155(12):1711–1717
Harrison PJ (2004) The hippocampus in schizophrenia: a review of the neuropathological evidence and its pathophysiological implications. Psychopharmacology (Berl) 174(1):151–162
Harrison PJ (2008) Neuropathology of schizophrenia. Psychiatry 7(10):421–424
Hooley JM, Delgado ML (2001) Pain insensitivity in the relatives of schizophrenia patients. Schizophr Res 47(2–3):265–273
Jensen-Dahm C, Werner MU, Dahl JB, Jensen TS, Ballegaard M, Hejl AM, Waldemar G (2014) Quantitative sensory testing and pain tolerance in patients with mild to moderate Alzheimer disease compared to healthy control subjects. Pain 155(8):1439–1445
Jochum T, Letzsc A, Greiner W, Wagner G, Sauer H, Bar KJ (2006) Influence of antipsychotic medication on pain perception in schizophrenia. Psychiatry Res 142(2–3):151–156
Karst M, Rahe-Meyer N, Gueduek A, Hoy L, Borsutzky M, Passie T (2005) Abnormality in the self-monitoring mechanism in patients with fibromyalgia and somatoform pain disorder. Psychosom Med 67(1):111–115
Keshavan MS, Tandon R, Boutros NN, Nasrallah HA (2008) Schizophrenia, “just the facts”: What we know in 2008: Part 3: Neurobiology. Schizophr Res 106(2):89–107
Kudoh A, Ishihara H, Matsuki A (2000) Current perception thresholds and postoperative pain in schizophrenic patients. Reg Anesth Pain Med 25(5):475–479
Larivière M, Goffaux P, Marchand S, Julien N (2007) Changes in pain perception and descending inhibitory controls start at middle age in healthy adults. Clin J Pain 23(6):506
Lautenbacher S, Kunz M, Strate P, Nielsen J, Arendt-Nielsen L (2005) Age effects on pain thresholds, temporal summation and spatial summation of heat and pressure pain. Pain 115(3):410–418
Leucht S, Burkard T, Henderson J, Maj M, Sartorius N (2007) Physical illness and schizophrenia: a review of the literature. Acta Psychiatr Scand 116(5):317–333
Lewis DA, Lieberman JA (2000) Catching up on schizophrenia: natural history and neurobiology. Neuron 28(2):325
Lewis DA, Hashimoto T, Volk DW (2005) Cortical inhibitory neurons and schizophrenia. Nat Rev Neurosci 6(4):312–324
Lorenz J, Minoshima S, Casey K (2003) Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation. Brain 126(5):1079–1091
Marchand WE, Sarota B, Marble HC, Leary TM, Burbank CB, Bellinger MJ (1959) Occurrence of painless acute surgical disorders in psychotic patients. N Engl J Med 260(12):580–585
Martins MJ, Moura BL, Martins IP, Figueira ML, Prkachin KM (2011) Sensitivity to expressions of pain in schizophrenia patients. Psychiatry Res 189(2):180–184
McWilliams LA, Cox BJ, Enns MW (2003) Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain 106(1):127–133
Melzack R, Casey KL (1968) Sensory, motivational and central control determinants of pain: a new conceptual model. Skin Senses 423–443
Meyer-Lindenberg AS, Olsen RK, Kohn PD, Brown T, Egan MF, Weinberger DR, Berman KF (2005) Regionally specific disturbance of dorsolateral prefrontal–hippocampal functional connectivity in schizophrenia. Arch Gen Psychiatry 62(4):379–386
Murakami H, Tamasawa N, Suda T (2010) Diminished pain perception in schizophrenia – authors’ reply. The Lancet 376(9735):87–88
Murthy BVS, Narayan B, Nayagam S (2004) Reduced perception of pain in schizophrenia: its relevance to the clinical diagnosis of compartment syndrome. Injury 35(11):1192–1193
Oosterman JM, Dijkerman HC, Kessels RPC, Scherder EJA (2010) A unique association between cognitive inhibition and pain sensitivity in healthy participants. Eur J Pain 14(10):1046–1050
Perlstein WM, Carter CS, Noll DC, Cohen JD (2001) Relation of prefrontal cortex dysfunction to working memory and symptoms in schizophrenia. Am J Psychiatry 158(7):1105–1113
Pickering G, Jourdan D, Eschalier A, Dubray C (2002) Impact of age, gender and cognitive functioning on pain perception. Gerontology 48(2):112–118
Popken GJ, Bunney WE, Potkin SG, Jones EG (2000) Subnucleus-specific loss of neurons in medial thalamus of schizophrenics. Proc Natl Acad Sci 97(16):9276
Portas CM, Goldstein JM, Shenton ME, Hokama HH, Wible CG, Fischer I, McCarley RW (1998) Volumetric evaluation of the thalamus in schizophrenic male patients using magnetic resonance imaging. Biol Psychiatry 43(9):649–659
Potvin S, Marchand S (2008) Hypoalgesia in schizophrenia is independent of antipsychotic drugs: a systematic quantitative review of experimental studies. Pain 138(1):70–78
Rosenthal SH, Porter KA, Coffey B (1990) Pain insensitivity in schizophrenia. Case report and review of the literature. Gen Hosp Psychiatry 12(5):319–322
Scherder E, Sergeant J, Swaab D (2003) Pain processing in dementia and its relation to neuropathology. Lancet Neurol 2(11):677–686
Scherder E, Oosterman J, Swaab D, Herr K, Ooms M, Ribbe M, Benedetti F (2005a) Recent developments in pain in dementia. BMJ 330(7489):461
Scherder E, Wolters E, Polman C, Sergeant J, Swaab D (2005b) Pain in Parkinson’s disease and multiple sclerosis: its relation to the medial and lateral pain systems. Neurosci Biobehav Rev 29(7):1047–1056
Sewards TV, Sewards MA (2002) The medial pain system: neural representations of the motivational aspect of pain. Brain Res Bull 59(3):163–180
Sigmundsson T, Suckling J, Maier M, Williams S, Bullmore E, Greenwood K, Toone B (2001) Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms. Am J Psychiatry 158(2):234
Stubbs B, Mitchell AJ, De Hert M, Correll CU, Soundy A, Stroobants M, Vancampfort D (2014) The prevalence and moderators of clinical pain in people with schizophrenia: A systematic review and large scale meta-analysis. Schizophrenia research 160(1):1–8
Tracey I, Mantyh PW (2007) The cerebral signature for pain perception and its modulation. Neuron 55(3):377–391
Treede RD, Kenshalo DR, Gracely RH, Jones AKP (1999) The cortical representation of pain. Pain 79(2–3):105–111
Valet M, Sprenger T, Boecker H, Willoch F, Rummeny E, Conrad B, Tolle TR (2004) Distraction modulates connectivity of the cingulo-frontal cortex and the midbrain during pain–an fMRI analysis. Pain 109(3):399–408
Vogt BA, Sikes RW (2000) The medial pain system, cingulate cortex, and parallel processing of nociceptive information. Prog Brain Res 122:223–235
Willis W, Westlund K (1997) Neuroanatomy of the pain system and of the pathways that modulate pain. J Clin Neurophysiol 14(1):2
Young KA, Manaye KF, Liang CL, Hicks PB, German DC (2000) Reduced number of mediodorsal and anterior thalamic neurons in schizophrenia. Biol Psychiatry 47(11):944–953
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Engels, G., Scherder, E. (2015). Clinical Pain in Schizophrenia: A Forgotten Area. In: Pickering, G., Gibson, S. (eds) Pain, Emotion and Cognition. Springer, Cham. https://doi.org/10.1007/978-3-319-12033-1_14
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DOI: https://doi.org/10.1007/978-3-319-12033-1_14
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