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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