Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T18:41:52.317Z Has data issue: false hasContentIssue false

Pain perception in patients with bipolar disorder and schizophrenia

Published online by Cambridge University Press:  24 June 2014

Levent Atik
Affiliation:
Zon guldak Karaelmas University, Faculty of Medicine, Department of Psychiatry, Zonguldak, Turkey
Numan Konuk*
Affiliation:
Zon guldak Karaelmas University, Faculty of Medicine, Department of Psychiatry, Zonguldak, Turkey
Omer Akay
Affiliation:
Zon guldak Karaelmas University, Faculty of Medicine, Department of Psychiatry, Zonguldak, Turkey
Devrim Ozturk
Affiliation:
Zon guldak Karaelmas University, Faculty of Medicine, Department of Psychiatry, Zonguldak, Turkey
Ayten Erdogan
Affiliation:
Zon guldak Karaelmas University, Faculty of Medicine, Department of Psychiatry, Zonguldak, Turkey
*
Dr. Numan Konuk, Zonguldak Karaelmas Univerrsitesi, Týp fakultesi Psikiyatri, AD Kozlu Zonguldak, Zonguldak 67600, Turkey. Tel: +90 372 2610169; Fax: +90 372 2610155; E-mail: [email protected]

Abstract

Objective:

Pain perception is reported to be altered in patients with depression and schizophrenia. However, few studies have investigated the pain perception in patients with bipolar disorders. We therefore aimed to compare pain sensitivity between patients with bipolar disorder, schizophrenia and controls.

Methods:

Study groups consisted of 30 patients with bipolar disorder, and control groups consisted of 27 patients with schizophrenia and 59 healthy subjects. Pain perception was assessed with cold pressor test (CPT) by exposure to ice-water.

Results:

Patients with schizophrenia had significantly higher pain thresholds (PTh) than patients with bipolar disorder. There were no differences between the PTh of patients with schizophrenia and healthy control subjects. However, patients with bipolar disorder had significantly lower pain tolerance (PT) in the CPT than patients with schizophrenia and corresponding healthy control subjects.

Conclusions:

The higher PTh in the schizophrenia group compared with the bipolar group found in this study supports further investigation of a potential difference in the pain perception between patients with schizophrenia and bipolar disorder. Theoretical implications of these findings and possible relevant behavioural and neurochemical mechanisms are discussed.

Type
Research Article
Copyright
Copyright © 2007 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adler, G, Gattaz, WF. Pain perception threshold in major depression. Biol Psychiatry 1993;34:687689. CrossRefGoogle ScholarPubMed
Guieu, R, Samuelian, JC, Coulouvrat, H. Objective evaluation of pain perception in patients with schizophrenia. Br J Psychiatry 1994;164:253255. CrossRefGoogle ScholarPubMed
Kemperman, I, Russ, M, Clark, WC, Kakuma, T, Zanine, E, Harrison, K. Pain assessments in self-injurious patients with borderline personality disorder using signal detection theory. Psychiatry Res 1997;70:175183. CrossRefGoogle ScholarPubMed
Russ, M, Clark, WC, Cross, L, Kemperman, I, Kakuma, T, Harrison, K. Pain and self-injury in borderline patients: sensory decision theory, coping strategies, and locus of control. Psychiatry Res 1996;63:5765. CrossRefGoogle ScholarPubMed
Dworkin, RH, Clark, WC, Lipsitz, JDet al. Affective deficits and pain insensitivity in schizophrenia. Motiv Emotion 1993;17:245276. CrossRefGoogle Scholar
Lautenbacher, S, Krieg, J. Pain perception in psychiatric disorders: a review of the literature. J Psychiatr Res 1994;28:109122. CrossRefGoogle ScholarPubMed
Hall, KRL, Stride, E. The varying response to pain in psychiatric disorders: a study in abnormal psychology. Br J Med Psychol 1954;27:4860. CrossRefGoogle ScholarPubMed
Colliins, LG, Stone, LA. Pain sensitivity, age and activity level in chronic schizophrenics and in normals. Br J Psychiatry 1966;112:3335CrossRefGoogle Scholar
Davis, GC, Buchsbaum, MS, Bunney, WE. Analgesia to painful stimuli in affective illness. Am J Psychiatry 1979;136:11481151. Google ScholarPubMed
von Knorring, L. An individual comparison of pain measures, averaged evoked responses and clinical ratings during depression and after recovery. Acta Psychiatr Scand Suppl 1974a;255:109120. CrossRefGoogle ScholarPubMed
von Knorring, L, Espvall, M. Experimentally induced pain in patients with depressive disorders. Acta Psychiatr Scand Suppl 1974b;255:121133. CrossRefGoogle ScholarPubMed
Lautenbacher, S, Spernal, J, Schreiber, W, Krieg, JC. Relationship between clinical pain complaints and pain sensitivity in patients with depression and panic disorder. Psychosom Med 1999;61:822827. CrossRefGoogle ScholarPubMed
Merskey, H. The effect of chronic pain upon the response to noxious stimuli by psychiatric patients. J Psychiatr Res 1965;22:119129. Google Scholar
Schreider, S, Shmueli, D, Grunhaus, L. The influence of electroconvulsive therapy on pain threshold and pain tolerance in major depression patients before, during and after treatment. Eur J Pain 2003;7:419424. CrossRefGoogle Scholar
Roy, R, Thomas, M, Matas, M. Chronic pain and depression: a review. Compr Psychiatry 1984;25:96105. CrossRefGoogle ScholarPubMed
Romano, JM, Turner, JA. Chronic pain and depression: does the evidence support a relationship? Psychol Bull 1985;97:1834. CrossRefGoogle ScholarPubMed
Gupta, MA. Is chronic pain a variant of depressive illness? A critical review. Can J Psychiatry 1986;31:241248. CrossRefGoogle ScholarPubMed
Atkinson, JH, Ingram, RE, Kremer, EF, Saccuzzo, DP. MMPI subgroups and affective disorder in chronic pain patients. J Nerv Ment Dis 1986;174:408413. CrossRefGoogle ScholarPubMed
Magni, G. On the relationship between chronic pain and depression when there is no organic lesion. Pain 1987;31:121. CrossRefGoogle ScholarPubMed
Atkinson, JH, Slater, MA, Patterson, TL, Grant, I, Garfin, SR. Prevalence, onset and risk of psychiatric disorders in men with chronic low back pain: a controlled study. Pain 1991;45:111121. CrossRefGoogle ScholarPubMed
Dworkin, RH, Gitlin, MJ. Clinical aspects of depression in chronic pain patients. Clin J Pain 1991;7:7994. CrossRefGoogle ScholarPubMed
Ruoff, GE. Depression in the patient with chronic pain. J Fam Pract 1996;43:2533. Google ScholarPubMed
Russ, MJ, Campbell, SS, Kakuma, T, Harrison, K, Zanine, E. EEG theta activity and pain insensitivity in self-injurious borderline patients. Psychiatry Res 1999;89:201214. CrossRefGoogle ScholarPubMed
Kemperman, I, Russ, MJ, Shearin, E. Self-injurious behavior and mood regulation in borderline patients. J Personal Disord 1997;11:146157. CrossRefGoogle ScholarPubMed
Bar, KJ, Brehm, S, Boettger, MK, Wagner, G, Boettger, S, Sauer, H. Decreased sensitivity to experimental pain in adjustment disorder. Eur J Pain 2006;10:467471. CrossRefGoogle ScholarPubMed
Pilowsky, I. Affective disorders and pain. In: Dubner, R, Gebhart, GF, Bond, MR, ed. Proceedings of the fifth world congress on pain: pain research and clinical management, Vol. 3. Amsterdam: Elsevier, 1988: 263275. Google Scholar
Craig, KD. Emotional aspects of pain. In: Wall, PD, Melzack, R, ed. Textbook of pain, 3rd edn. Edinburg: Churchill Livingstone, 1994: 261274. Google Scholar
Marazziti, D, Mungai, F, Vivarelli, L, Presta, S, Dell’Osso, B. Pain and psychiatry: a critical analysis and pharmacological review. Clin Pract Epidemol Ment Health 2006;2:31. CrossRefGoogle ScholarPubMed
Schreiber, S, Getslev, V, Backer, MM, Weizman, R, Pick, CG. The atypical neuroleptics clozapine and olanzapine differ regarding their antinociceptive mechanisms and potency. Pharmacol Biochem Behav 1999;64:7580. CrossRefGoogle ScholarPubMed
Dworkin, RH, Clark, WC, Lipsitz, JD. Pain responsivity in major depression and bipolar disorder. Psychiatry Res 1995;56:173181. CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured clinical interview for DSM-IV axis I disorders—clinician version (SCID-CV). Washington, DC: American Psychiatric Press, 1997. Google Scholar
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978;133:429435. CrossRefGoogle ScholarPubMed
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:5662. CrossRefGoogle ScholarPubMed
Overall, JF, Gorham, DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962;10:799812. CrossRefGoogle Scholar
Guy, WA, Rush, J, Pincus, HA, First, MB, eds. Clinical global impression. In: Handbook of psychiatric measures. Washington, DC: APA, 2000:218222. Google Scholar
Hilgard, ER. Pain as a puzzle for psychology and physiology. Am Psychol 1969;24:103113. CrossRefGoogle Scholar
Lebaron, S, Zeltzer, L, Fanurik, D. An investigation of cold pressor pain in children (part I). Pain 1989;37:161171. CrossRefGoogle ScholarPubMed
Chen, ACN, Dworkin, SF, Haug, J, Gehr, GJ. Topografic brain measures of human pain and pain responsivity. Pain 1989;37:129141. CrossRefGoogle Scholar
Williams, LJ, Jacka, FN, Pasco, JA, Dodd, S, Berk, M. Depression and pain: an overview. Acta Neuropsychiatrica 2006;18:7987. CrossRefGoogle ScholarPubMed
Buchsbaum, M, Davies, GC, Goodwin, FK, Murphy, DL, Post, RM. Psychophysical pain judgments and somatosensory evoked potentials in patients with affective illness and in normal adults. Adv Biol Psychiatry 1980;4:6372. CrossRefGoogle Scholar
Lautenbacher, S, Kreig, J. Pain perception in psychiatric disorders: a review of the literature. J Psychiatr Res 1994;18:109122. CrossRefGoogle Scholar
Merskey, H, Lundblom, U, Mumford, JM, Nathan, PW, Sunderland, S. Pain terms. A current list with definitions and notes of usage. In: Meskey, H, Bogduk, N, ed. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms, 2nd edn. Seattle, WA: IASP Press, 1994: 207213. Google Scholar
Dworkin, RH. Pain insensitivity in schizophrenia: a neglected phenomenon and some implications. Schizophr Bull 1994;20:235248. CrossRefGoogle ScholarPubMed
Blumensohn, R, Ringler, D, Eli, I. Pain perception in patients with schizophrenia. J Nerv Ment Dis 2002;190:481483. CrossRefGoogle ScholarPubMed
Eli, I, Bar-Tal, Y, Fuss, Z, Korff, E. Effect of biological sex differences on the perception of acute pain stimulation in the dental setting. Pain Res Manage 1996;1:201206. CrossRefGoogle Scholar
Eli, I, Bar-Tal, Y, Fuss, Z, Silberg, A. Effect of intended treatment on anxiety and on relation to electric pulp stimulation in dental patients. J Endod 1997;23:694697. CrossRefGoogle Scholar
Fishbain, D. Pain insensitivity in psychosis. Ann Emerg Med 1982;11:630632. CrossRefGoogle ScholarPubMed
Decina, P, Mukherjee, S, Caracci, G, Harrison, K. Painful sensory symptoms in neuroleptic-induced extrapyramidal syndromes. Am J Psychiatry 1992;149:10751080. Google ScholarPubMed