title: When patients do not hurt: silent acute abdomen in a patient with schizophrenia.
abstract: The phenomenon of pain insensitivity in schizophrenia and other psychotic disorders has been described since the early 20th century. Medical conditions often present atypically in the seriously mentally ill patient. Emergency physicians, primary care practitioners, surgeons and psychiatrists must maintain a high index of suspicion for acute abdomen in seriously mentally ill patients who may exhibit a diminished or absent perception of pain. The authors present a case of an atypical presentation of acute abdomen in a patient with schizophrenia.
authors.affiliation: Department of Psychiatry and Behavioral Science, Temple University School of Medicine, Philadelphia, PA, USA. retamero@temple.edu
authors.forename: Carolina
authors.initials: C
authors.lastname: Retamero
authors.forename: Camille
authors.initials: C
authors.lastname: Paglia
mesh_terms: D000006:Abdomen, Acute / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000328:Adult; D006801:Humans; D008297:Male; D058748:Pain Perception; D011859:Radiography; D012559:Schizophrenia / Q000150:complications