title: Alteration of pain recognition in schizophrenia.
abstract: BACKGROUND
  Schizophrenia patients display impaired recognition of their own emotions and those of others and deficits in several domains of empathy. The first-person experience of pain and observing others in pain normally trigger strong emotional mechanisms. We therefore hypothesized that schizophrenia patients would display impaired recognition and categorization of both their own pain and the pain of others.
  
  
  METHODS
  We studied 29 patients (18 men/11 women; 36 ± 13 years old) with paranoid schizophrenia-spectrum disorder and 27 healthy volunteers (20 men/7 women; 31 ± 9 years old) matched for age, gender, IQ and socio-cultural level. We assessed symptom severity and theory of mind. The participants' ability to detect and categorize pain in others was assessed with the sensitivity to expressions of pain (STEP) test, which is based on facial expressions, and another dynamic test involving a series of video sequences showing various pain-inducing events. The ability of patients to evaluate their own pain was assessed with the situational pain questionnaire (SPQ), which includes a series of questions assessing how one would expect to feel in different imaginary situations. Empathic tendencies were assessed with the interpersonal reactivity index.
  
  
  RESULTS
  Patients and controls differed significantly in STEP, pain video and SPQ scores. By contrast with control subjects, the patients' pain judgements were not correlated with their affective or cognitive empathic capacities.
  
  
  CONCLUSIONS
  Schizophrenic patients have a deficit of the identification and categorization of pain both in themselves and in others.
authors.affiliation: Unité de Recherche Clinique, Neuilly sur Marne, France.
authors.forename: A
authors.initials: A
authors.lastname: Wojakiewicz
authors.forename: D
authors.initials: D
authors.lastname: Januel
authors.forename: S
authors.initials: S
authors.lastname: Braha
authors.forename: K
authors.initials: K
authors.lastname: Prkachin
authors.forename: N
authors.initials: N
authors.lastname: Danziger
authors.forename: D
authors.initials: D
authors.lastname: Bouhassira
mesh_terms: D000328:Adult; D001364:Awareness / Q000502:physiology; D004644:Emotions / Q000502:physiology; D004645:Empathy / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000523:psychology*; D058748:Pain Perception / Q000502:physiology*; D021641:Recognition, Psychology / Q000502:physiology*; D012559:Schizophrenia / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012938:Social Perception; D056345:Theory of Mind / Q000502:physiology