Pain insensitivity in schizophrenia. Case report and review of the literature

Gen Hosp Psychiatry. 1990 Sep;12(5):319-22. doi: 10.1016/0163-8343(90)90050-m.


We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illnesses in which pain is characteristically a prominent presenting symptom. While research into the cause of altered pain perception in psychotic patients is continuing, clinicians should maintain a high index of suspicion of serious medical illness when evaluating such patients.

Publication types

  • Case Reports

MeSH terms

  • Abdomen, Acute / psychology*
  • Abdomen, Acute / surgery
  • Adult
  • Delusions / psychology
  • Denial, Psychological
  • Humans
  • Hypesthesia / psychology*
  • Ileal Diseases / psychology*
  • Ileal Diseases / surgery
  • Intestinal Perforation / psychology*
  • Intestinal Perforation / surgery
  • Male
  • Pain, Postoperative / psychology
  • Schizophrenia / diagnosis*
  • Schizophrenic Psychology*