Reduced pain perception in patients with schizophrenia; A missed case of hand fracture

Document Type

Journal Article

Publication Date

1-1-2021

Journal

American Journal of Emergency Medicine

DOI

10.1016/j.ajem.2021.04.080

Keywords

Emergency department; Pain perception; Psychosomatic; Schizophrenia

Abstract

Altered pain perception among patients with schizophrenia is often underrecognized in the medical community. The cause is not known, and medical professionals are not sure whether these patients experience less pain or are simply unable to express it. There are documented cases of patients with schizophrenia presenting to hospital settings with serious injuries without obvious (expected) pain. Research into the underlying cause(s) is underway; meanwhile, ensuring awareness of this issue among medical providers is of upmost importance. We report a case of a patient with schizophrenia who presented voluntarily to the emergency department (ED) with a hand fracture that went unrecognized in the ED and further discuss the implications of reduced pain perception. Additionally, we summarize existing hypotheses regarding the source of this reduced pain perception in this population.

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