title: Clinical pain in schizophrenia: a systematic review.
abstract: Studies about clinical pain in schizophrenia are rare. Conclusions on pain sensitivity in people with schizophrenia are primarily based on experimental pain studies. This review attempts to assess clinical pain, that is, everyday pain without experimental manipulation, in people with schizophrenia. PubMed, PsycINFO, Embase.com, and Cochrane were searched with terms related to schizophrenia and pain. Methodological quality was assessed with the Mixed Methods Appraisal Tool. Fourteen studies were included. Persons with schizophrenia appear to have a diminished prevalence of pain, as well as a lower intensity of pain when compared to persons with other psychiatric diseases. When compared to healthy controls, both prevalence and intensity of pain appear to be diminished for persons with schizophrenia. However, it was found that this effect only applies to pain with an apparent medical cause, such as headache after lumbar puncture. For less severe situations, prevalence and intensity of pain appears to be comparable between people with schizophrenia and controls. Possible underlying mechanisms are discussed. Knowledge about pain in schizophrenia is important for adequate pain treatment in clinical practice.
  
  
  CONCLUSIONS
  This review presents a valuable insight into clinical pain in people with schizophrenia.
authors.affiliation: Department of Clinical Neuropsychology, Vrije Universiteit, The Netherlands. Electronic address: g.engels@vu.nl.
authors.forename: Gwenda
authors.initials: G
authors.lastname: Engels
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL) and EMGO+ VU Medical Center, The Netherlands.
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.affiliation: Department of Health, Sports and Welfare, Cluster Nursing, Inholland University of Applied Sciences and Parnassia Psychiatric Institute, The Netherlands.
authors.forename: Berno
authors.initials: B
authors.lastname: van Meijel
authors.affiliation: Department of Clinical Neuropsychology, Vrije Universiteit, The Netherlands.
authors.forename: Johanna G
authors.initials: JG
authors.lastname: Douma
authors.affiliation: GGz Centraal, Center for Mental Healthcare, The Netherlands.
authors.forename: Heidi
authors.initials: H
authors.lastname: de Kam
authors.affiliation: GGz Centraal, Center for Mental Healthcare, The Netherlands.
authors.forename: Wubbien
authors.initials: W
authors.lastname: Wesselink
authors.affiliation: GGZ-VS School for Masters of Advanced Nursing Practice, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Houtjes
authors.affiliation: Department of Clinical Neuropsychology, Vrije Universiteit, The Netherlands.
authors.forename: Erik J A
authors.initials: EJ
authors.lastname: Scherder
mesh_terms: D006801:Humans; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology*; D017288:Pain Threshold / Q000502:physiology; D012559:Schizophrenia / Q000453:epidemiology / Q000503:physiopathology*
keywords: Clinical pain; prevalence and intensity of pain; schizophrenia