Pain insensitivity in schizophrenia. Case report and review of the literature.
We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illnesses in which pain is characteristically a prominent presenting symptom. While research into the cause of altered pain perception in psychotic patients is continuing, clinicians should maintain a high index of suspicion of serious medical illness when evaluating such patients.
Metropolitan State Hospital, Waltham, Massachusetts.
S H
SH
Rosenthal
K A
KA
Porter
B
B
Coffey
D000006:Abdomen, Acute / Q000523:psychology* / Q000601:surgery; D000328:Adult; D003702:Delusions / Q000523:psychology; D003717:Denial, Psychological; D006801:Humans; D006987:Hypesthesia / Q000523:psychology*; D007077:Ileal Diseases / Q000523:psychology* / Q000601:surgery; D007416:Intestinal Perforation / Q000523:psychology* / Q000601:surgery; D008297:Male; D010149:Postoperative Pain / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology