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Douleur et schizophrénie : quand l’esprit ignore les appels grandissants de la moelle

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Santé mentale et douleur

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Résumé

La douleur est un signal d’alarme indiquant que notre organisme est potentiellement en danger. Il s’agit donc d’une expérience sensorielle et émotionnelle nécessaire à notre survie. Sans ce signal, nous aurions tendance à nous placer dans des situations dangereuses pour notre santé. Le syndrome d’insensibilité (ou d’indifférence) congénitale à la douleur illustre bien ce propos. Les enfants atteints de ce syndrome ont tendance, en effet, à se blesser constamment, ils n’apprennent pas à éviter des situations de danger (exemple : le rond de poêle allumé), et en bout de ligne, ils ont une espérance de vie substantiellement réduite par rapport à la population générale [1]. Chez les personnes atteintes de schizophrénie, on soupçonne depuis les observations pionnières de Kraepelin et de Bleuler qu’il y aurait une indifférence relative, voire une insensibilité, à la douleur. Cette notion d’hypoalgésie dans la schizophrénie demeure toutefois controversée [2], mais elle gagne à être étudiée davantage, car les patients atteints de schizophrénie peuvent hésiter à consulter les services de santé, alors qu’ils sont pourtant plus à risque que la population générale de développer divers problèmes médicaux, tels que le virus d’immunodéficience humaine, des hépatites, l’ostéoporose, des dysfonctions sexuelles, des troubles cardiovasculaires, l’obésité, le diabète, des problèmes dentaires et la polydipsie [3].

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Références

  1. Nagasako EM, Oaklander AL, Dworkin RH (2003) Congenital insensitivity to pain: an update. Pain 101(3): 213–219

    Article  PubMed  Google Scholar 

  2. Bonnot O, Anderson GM, Cohen D et al. (2009) Are patients with schizophrenia insensitive to pain? A reconsideration of the question. Clin J Pain 25(3): 244–252

    Article  PubMed  Google Scholar 

  3. Leucht S, Burkard T, Henderson J et al. (2007) Physical illness and schizophrenia: a review of the literature. Acta Psychiatr Scand 116: 317–333

    Article  PubMed  CAS  Google Scholar 

  4. Singh MK, Giles LL, Nasrallah HA (2006) Pain insensitivity in schizophrenic: trait or state marker? J Psychiatr Pract 12: 90–102

    Article  PubMed  Google Scholar 

  5. Rosenthal SH, Porter KA, Coffey G (1990) Pain insensitivity in schizophrenia: case report and review of the literature. Gen Hosp Psychiatry 12: 319–322

    Article  PubMed  CAS  Google Scholar 

  6. Large M, Babidge N, Andrews D et al. (2009) Major self-stimulation in the first episode of psychosis. Schizophr Bull 35(5): 1012–1021

    Article  PubMed  Google Scholar 

  7. Dworkin RH (1994) Pain insensitivity in schizophrenia: a neglected phenomenon and some implications. Schizophr Bull 20: 235–248

    Article  PubMed  CAS  Google Scholar 

  8. Fishbain DA, Goldberg M, Meagher BR et al. (1986) Male and female chronic pain patients categorized by psychiatric diagnostic criteria. Pain 26: 181–197

    Article  PubMed  CAS  Google Scholar 

  9. Blumensohn R, Ringler D, Eli I (2002) Pain perception in patients with schizophrenia. J Nerv Ment Dis 190: 481–483

    Article  PubMed  Google Scholar 

  10. Jochum T, Letzsch A, Greiner W et al. (2006) Influence of antipsychotic medication on pain perception in schizophrenia. Psychiatry Res 142: 151–156

    Article  PubMed  CAS  Google Scholar 

  11. Kudoh A, Ishihara H, Matsuki A (2000) Current perception thresholds and postoperative pain in schizophrenic patients. Reg Anesth Pain Med 25: 475–479

    PubMed  CAS  Google Scholar 

  12. Collins GL, Stone LA (1966) Pain sensitivity, age and activity level in chronic schizophrenics and normals. Brit J Psychiatry 112: 33–35

    Article  Google Scholar 

  13. Guieu R, Samuélan JC, Coulouvrat H (1994) Objective evaluation of pain perception in patients with schizophrenia. Brit J Psychiatry 164: 253–255

    Article  CAS  Google Scholar 

  14. Atik L, Konuk N, Akay O et al. (2007) Pain perception in patients with bipolar disorder and schizophrenia. Acta Neuropsychiatr 19: 284–290

    Article  Google Scholar 

  15. Goldman MB, Gnerlich J, Hussain N (2007) Neuroendocrine responses to cold pressor stimulus in polydipsic hyponatremic and in matched schizophrenic patients. Neuropsychopharmacology 32: 1611–1621

    Article  PubMed  CAS  Google Scholar 

  16. Potvin S, Stip E, Lipp O et al. (2008) Pain perception in schizophrenia: no changes in diffuse noxious inhibitory controls (DNIC) but a lack of pain sensitization to thermal pain in schizophrenia. J Psychiatr Res 42(12): 1010–1016

    Article  PubMed  Google Scholar 

  17. Dworkin RH, Clark CW, Lipsitz JD et al. (1993a, b) Affective deficits and pain insensitivity in schizophrenia. Motiv Emotion 17(3): 245–276

    Article  Google Scholar 

  18. Potvin S, Marchand S (2008) Hypoalgesia in schizophrenia is independent of antipsychotic drugs: A systematic quantitative review. Pain 138(1): 70–78

    Article  PubMed  CAS  Google Scholar 

  19. Davis GC, Buchsbaum MS, van Kammen DP et al. (1979) Analgesia to pain stimuli in schizophrenics and its reversal by naltrexone. Psychiatry Res 1: 61–69

    Article  PubMed  CAS  Google Scholar 

  20. Song JY, Yi JH (2000) Pain insensitivity and pressure pain thresholds in patients with schizophrenia. J Korean Neuropsychiatr Assoc 39: 14–21

    Google Scholar 

  21. Lévesque M, Potvin S, Stip E et al. (2011) Lack of pain sensitization in schizophrenia is related to differences in supra-spinal but not spinal pain processing. American Pain Society Annual Scientific Meeting. Austin, États-Unis.

    Google Scholar 

  22. Fahim C, Stip E, Mancini-Marie A et al. (2005) Brain activity during emotionally negative pictures in schizophrenia with and without flat affect: an fMRI study. Psychiatry Res 140: 1–15

    Article  PubMed  Google Scholar 

  23. Rainville P, Duncan GH, Price DD et al. (1997) Pain affect encoded in the human anterior cingulate but not somatosensory cortex. Science 277: 968–971

    Article  PubMed  CAS  Google Scholar 

  24. Nuechterlein KH, Barch DM, Gold JM et al. (2004) Identification of seperable cognitive factors in schizophrenia. Schizophr Res 72(1): 29–39

    Article  PubMed  Google Scholar 

  25. Arendt-Nielsen L, Brennum J, Sindrup S et al. (1994) Electrophysiological and psychophysical quantification of temporal summation in the human nociceptive system. Eur Appl Physiol Occup Physiol 68: 266–273

    Article  CAS  Google Scholar 

  26. Price DD, Mao J, Frenk H et al. (1994) The N-methyl-D-aspartate receptor antagonist dextromethorphan selectively reduces temporal summation of second pain in man. Pain 59: 165–174

    Article  PubMed  CAS  Google Scholar 

  27. Chevlen E, Davis PS, Rhiner M (2005) From mechanisms to management: translating the neuropathic pain consensus recommendations into clinical practice. J Am Acad Nurse Pract 17: 3–17

    Article  PubMed  Google Scholar 

  28. Le Bars D, Dickenson AH, Besson JM (1979a) Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurons in the rat. Pain 6: 283–304

    Article  PubMed  Google Scholar 

  29. Le Bars D, Dickenson AH, Besson JM (1979b) Diffuse noxious inhibitory controls (DNIC). II, Lack of effect on non-convergent neurones, supraspinal involvement and theoretical implications. Pain 6: 305–327

    Article  PubMed  Google Scholar 

  30. Willer JC, Bouhassira D, Le Bars D (1999) Neurophysiological bases of the counterirritation phenomenon: diffuse control inhibitors induced by nociceptive stimulation. Neurophysiol Clin 29: 379–400

    Article  PubMed  CAS  Google Scholar 

  31. Marchand S (2008) The physiology of pain mechanisms: from the periphery to the brain. Rheum Dis Clin North Am 34(2): 285–309

    Article  PubMed  Google Scholar 

  32. Julien N, Goffaux P, Arsenault P et al. (2005) Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain 114: 295–302

    Article  PubMed  Google Scholar 

  33. Tousignant-Laflamme Y, Pagé S, Goffaux P et al. (2008) An experimental model to measure excitatory and inhibitory pain mechanisms in humans. Brain Res 1230: 73–79

    Article  PubMed  CAS  Google Scholar 

  34. Jentsch DJ, Roth RH (1999) The neuropsychopharmacology of phencyclidine: from NMDA receptor hypofunction to the dopamine hypothesis of schizophrenia. Neuropsychopharmacology 20: 201–225

    Article  PubMed  CAS  Google Scholar 

  35. Marchesi GF, Santone G, Cotani P et al. (1995) The therapeutic role of naltrexone in negative symptom schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 19(8): 1239–1249

    Article  PubMed  CAS  Google Scholar 

  36. Sernyak MJ, Glazer WM, Heninger GR et al. (1998) Naltrexone augmentation of neuroleptics in schizophrenia. J Clin Psychopharmacol 18(3): 248–251

    Article  PubMed  CAS  Google Scholar 

  37. Hooley JM, Delgado ML (2001) Pain insensitivity in the relatives of schizophrenic patients. Schizophr Res 47: 265–273

    Article  PubMed  CAS  Google Scholar 

  38. Howe OD, Kapur S (2009) The dopamine hypothesis of schizophrenia: version III — the final common pathway. Schizophr Bull 35(3): 549–562

    Article  Google Scholar 

  39. Potvin S, Grignon S, Marchand S (2009) Human evidence of a supra-spinal modulating role of dopamine on pain perception. Synapse 63(5): 390–402

    Article  PubMed  CAS  Google Scholar 

  40. Diatchenko L, Nackley AG, Slade GD et al. (2006) Catechol-O-methyltransferase gene polymorphisms are associated with multiple pain-evoking stimuli. Pain 125: 216–224

    Article  PubMed  CAS  Google Scholar 

  41. Potvin S, Larouche A, Normand E et al. (2009) The DRD3 Ser9Gly polymorphism is related to thermal pain in chronic widespread pain patients and healthy volunteers. J Pain 10(9): 969–975

    Article  PubMed  CAS  Google Scholar 

  42. Walsh J, Tighe O, Lei D et al. (2010) Disruption of themal nociceptive behavior in mice mutant for the schizophrenia-associated genges NRG1, COMT and DISC-1. Brain Res 1348: 114–119

    Article  PubMed  CAS  Google Scholar 

  43. Goffaux P, Redmond WJ, Rainville P et al. (2007) Descending analgesia — when the spine echoes what the brain expects. Pain 130(1–2): 137–143

    Article  PubMed  Google Scholar 

  44. Stip E, Caron J, Renaud S et al. (2003) Exploring cognitive complaints in schizophernia: the subjective scale to investigate cognition in schizophrenia. Compr Psychiatry 44(4): 331–340

    Article  PubMed  CAS  Google Scholar 

  45. Meltzer HY, Li Z, Ichikawa J (2003) Serotonin receptors: Their key role in drugs to treat schizophrenia. Progr Neuropsychopharmacol Biol Psychiatry 27: 1159–1172

    Article  CAS  Google Scholar 

  46. Seeman P (2002) Atypical antipsychotics: Mechanism of action. Can J Psychiatry 47: 27–38

    PubMed  Google Scholar 

  47. Altier N, Stewart J (1999) The role of dopamine in the nucleus accumbens in analgesia. Life Sci 65: 2269–2287

    Article  PubMed  CAS  Google Scholar 

  48. Gear RW, Aley KO, Levine JD (1999) Pain-induced analgesia mediated by mesolimbic reward circuits. J Neurosci 19: 7175–7181

    PubMed  CAS  Google Scholar 

  49. Siow HC, Young WB, Silberstein SD (2005) Neuroleptics in headache. Headache 45: 358–371

    Article  PubMed  Google Scholar 

  50. Fishbain DA, Cutler RB, Lewis J et al. (2004) Do the second-generation “atypical neuroleptics” have analgesic properties? A structured evidence-based review. Pain Med 5: 359–365

    Article  PubMed  Google Scholar 

  51. Dong XW, Jia Y, Lu SX et al. (2008) The antipsychotic drug, fluphenazine, effectively reverses mechanical allodynia in rat models of neuropathic pain. Psychopharmacology 195: 559–568

    Article  PubMed  CAS  Google Scholar 

  52. Monteleone P, Martiadis V, Maj M (2009) Management of schizophrenia with obesity, metabolic, and endocrinological disorders. Psychiatr Clin North Am 32(4): 775–794

    Article  PubMed  Google Scholar 

  53. Franklin KB (1998) Analgesia and abuse potential: an accidental association or a common substrate? Pharmacol Biochem Behav 59(4): 993–1002

    Article  PubMed  CAS  Google Scholar 

  54. Regier DA, Farmer ME, Rae DS et al. (1990) Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) study. JAMA 264(19): 2511–2518

    Article  PubMed  CAS  Google Scholar 

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  1. Centre de recherche Fernand-Séguin, 7331, rue Hochelaga, Montréal, Québec, Canada, H1N 3V2

    S. Potvin

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Potvin, S. (2013). Douleur et schizophrénie : quand l’esprit ignore les appels grandissants de la moelle. In: Santé mentale et douleur. Springer, Paris. https://doi.org/10.1007/978-2-8178-0307-4_9

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  • DOI: https://doi.org/10.1007/978-2-8178-0307-4_9

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0306-7

  • Online ISBN: 978-2-8178-0307-4

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