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SCHIZOPHRENIA PATIENTS' INSENSITIVITY TO PAIN CAN BE LIFE THREATENING

A literature search by Dr. Robert H. Dworkin of Columbia-Presbyterian Medical

Center, New York, has turned up many reports of individuals with

schizophrenia being insensitive to physical pain associated with illness and

injury. One researcher found that pain was absent in 21 percent of

schizophrenia patients with acute perforated peptic ulcers and in 37 percent

of those with acute appendicitis.

 

Among a group of schizophrenia patients who had experienced a myocardial

infarction (heart attack), only 18 percent reported pain, although 90 percent

of heart-attack patients without schizophrenia report severe pain. When

researchers studied the autopsy reports of a "large sample" of schizophrenia

patients, of whom almost one-third of those over 40 had died suddenly, they

attributed the cause for many of those sudden deaths to painless myocardial

infarction, and uncomplaining patients with some abdominal catastrophe.

 

This reduced sensitivity to pain turns up in a variety of other medical

conditions: in fractures, third-degree burns, cancer, peptic ulcers, and

arthritis. Surgeons report that schizophrenia patients rarely complain when

wounds are sutured or from postoperative pain. When researchers observed a

sample of 31 children with schizophrenia over a period of one to three years,

they noted that the children displayed "diminished or absent reactions" to

physical injuries that cause pain in normal children, including cuts,

bruises, burns, inflammation, and dental treatment.

 

Insensitivity to pain can have severe, even life-threatening-implications for

an individual's physical health. "Because pain is a symptom of many

illnesses, insensitivity can delay recognition of a condition requiring

diagnosis and treatment. In addition, pain serves as a warning signal" that

would otherwise leave us vulnerable to injury or severe infection.

 

Reduced sensitivity to pain appears to be linked to the self-injurious

behavior and incidents of self-mutilation that occur with some individuals

with schizophrenia. It may also be what makes homeless persons with

schizophrenia more able to tolerate their homelessness, but also makes them

more likely to be injured in an accident or victimized. ...

(From Schizophrenia Bulletin, Vol. 20, No. 2, 1994)

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