Résumé
L’insensibilité à la douleur chez les patients schizophrènes est suggérée par les observations cliniques, les études des cas et les études expérimentales. L’analyse de la littérature ne permet pas de conclure à une réelle analgésie chez les patients schizophrènes mais à un mode d’expression différent de la douleur, un langage et un comportement en lien avec la pathologie psychiatrique. Les travaux récents viennent confirmer cette hypothèse.
Abstract
Several lines of evidence (case report, epidemiological studies, experimental studies) suggest that patients with schizophrenia show an insensitivity to pain. We reviewed the literature on this specific topic. There is a lack of evidence to prove a real analgesia. Patients with schizophrenia express their emotion in general and pain in particular in a different way. The most recent research works confirm this hypothesis. Patients feel pain but do not express it by adapted social skills.
Références
Albus M, Ackenheil M, Engel RR, Müller F (1982) Situational reactivity of autonomic functions in schizophrenia patients. Psychiatry Res 6:361–370
Apter JT (1981) The “silent” acute abdomen of schizophrenia. J Med Soc N J 78:679–680
Arena JG (2002) Chronic pain: psychological approaches for the front-line clinician. J Clin Psychol 58:1385–1396
Ballenger JC, Post RM, Sternberg DE, et al (1979) Headaches after lumbar puncture and insensitivity to pain in psychiatric patients. N Engl J Med 301:110
Bender L, Schilder P (1930) Unconditioned and conditions reactions to pain in schizophrenia. Am J Psychiatry 87:365–384
Bickerstaff LK, Harris SC, Leggett RS, Cheah KC (1988) Pain insensitivity in schizophrenic patients. A surgical dilemma. Arch Surg 123:49–51
Bleuler M, Bleuler R (1986) Dementia praecox oder die Gruppe der Schizophrenien: Eugen Bleuler. Br J Psychiatry 149:661–662
Chatuverdi SK (1989) Pain sensitivity in psychosis and the endorphin theory of psychosis. Adv Biosci 75:687–690
Clay GS, Brougham LR (1975) Haloperidol binding to an opiate receptor site. Biochem Pharmacol 24:1363–1367
Davis GC, Buchsbaum MS, Bunney WE Jr (1979) Research in endorphins and schizophrenia. Schizophr Bull 5:244–250
Davis GC, Buchsbaum MS, Naber D, et al (1982) Altered pain perception and cerebrospinal endorphins in psychiatric illness. Ann NY Acad Sci 398:366–373
Dworkin RH (1994) Pain insensitivity in schizophrenia: a neglected phenomenon and some implications. Schizophr Bull 20:235–248
Dworkin RH, Caligor E (1988) Psychiatric diagnosis and chronic pain: DSM-III-R and beyond. J Pain Symptom Manage 3:87–98
Dworkin RH, Clark WC, Lipsitz JD, et al (1993) Affective deficit and pain insensitivity in schizophrenia. Motiv Emot 17: 245–276
Earle A, Earle BV (1955) The blood pressure response to pain and emotion in schizophrenia. J Nerv Ment Dis 121:132–139
Fishbain D (1982) Pain insensitivity in psychosis. Ann Emerg Med 11:630–632
Foucault M (1972) Histoire de la folie à l’âge classique. Gallimard, Paris
Geschwind N (1977) Insensitivity to pain in psychotic patients. N Engl J Med 296:1480
Guieu R, Samuélian JC, Coulouvrat H (1994) Objective evaluation of pain perception in patients with schizophrenia. Br J Psychiatry 164:253–255
Heresco-Levy U, Javitt DC (1998) The role of NMDA receptormediated neurotransmission in the patho-physiology and therapeutics of psychiatric syndromes. Eur Neuropsychopharmacol 8:141–152
Hussar AE (1996) Leading causes of death in institutionalized chronic schizophrenic patients; a study of 1,275 autopsy protocols. J Nerv Ment Dis 142:45–57
Javitt DC, Balla A, Burch S, et al (2004) Reversal of phencyclidine-induced dopaminergic dysregulation by N-methyl-D-aspartate receptor/glycine-site agonists. Neuropsychopharmacology 29:300–307
Julien N, Marchand S (2006) Endogenous pain inhibitory systems activated by spatial summation are opioid-mediated. Neurosci Lett 401:256–260
Katz E, Kluger Y, Rabinovici R, et al (1990) Acute surgical abdominal disease in chronic schizophrenic patients: a unique clinical problem. Isr J Med Sci 26:275–277
Kraeplin E (1919) Dementia praecox et paraphrenia ES. Livingstone, Scotland
Lewis C (1937) Diagnostic problems of acute surgical conditions of the abdomen in psychotic patients. Med Bull Veterans Admin 13:314–320
Malbie AA, Cavenar JO, Sullivan JL, et al (1979) Analgesia and haloperidol: a hypothesis. J Clin Psychiatry 40:323–326
Marchand S, Potvin S, et al (2008) De l’hypoalgésie à l’hyperalgésie. La lettre de l’IUD 28
Marchand WE (1955) Occurrence of painless myocardial infarction in psychotic patients. N Engl J Med 253:51–55
Marchand WE (1958) The practice of medicine in a neuropsychiatric hospital. AMA Arch Neurol Psychiatry 80:599–611
Marchand WE (1959) Practice of surgery in a neuropsychiatric hospital. Arch Gen Psychiatry 1:123–131
Marchand WE, Sarota B, Marble H, et al (1959) Occurrence of painless acute surgical disorders in psychotic patients. N Engl J Med 260:580–585
Merskey H, Gillis A, Marszalek KS (1962) A clinical investigation of reaction to pain. J Ment Sci 108:347–355
Potvin S, Stip E, Tempier R, et al (2007) Deficient pain sensitization in schizophrenia. In: Third international forum on pain. Communication affichée, Montréal no 37
Pellizzi GB (1896) Fenomeni di analgesia nelle malatie mentali. Annali di Frenatria
Petrovich DV (1960) Pain perception in chronic schizophrenics. J Projective Techn 24:21–27
Pinel (An 10) Traité médicophilosophique, Paris. pp 60–61
Rosenthal SH, Porter KA, Coffey B (1990) Pain insensitivity in schizophrenia, case report and review of the literature. Gen Hosp Psychiatry 12:319–322
Shattock FM, Oxon MA, London DP (1950) The somatic manifestation of schizophrenia: a clinical study of their significance. J Ment Sci 96:32–142
Spear FG (1967) Pain in psychiatric patients. J Psychosom Res 11:187–193
Torrey EF (1979) Headaches after lumbar puncture and insensitivity to pain in psychiatric patients. N Engl J Med 301:110
Watson GD, Chandarana PC, Merskey H (1981) Relationships between pain and schizophrenia. Br J Psychiatry 138:33–36
Willer JC (1984) Nociceptive flexion reflex as a physiological correlate of pain sensations in humans. In: Bromm B. (ed) Pain measurement in man. Neurophysiollogical correlate of pain. Elsevier, Amsterdam, pp 87–110
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Saravane, D. Historique de la douleur en santé mentale. Douleur analg 24, 171–175 (2011). https://doi.org/10.1007/s11724-011-0256-6
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DOI: https://doi.org/10.1007/s11724-011-0256-6