[Characteristics and prevalence of painful coenesthesia in a pain clinic]

Coenesthesia, a rarely described symptom, is classified as schizophrenia according to ICD-10 and can occur independently of psychiatric diseases as a form of pain. The prevalence in chronic pain disorders is still unknown. The present study investigates the characteristics and psychological comorbidities of painful coenesthesia.

For the present study, all patients were pseudonymized and retrospectively analyzed qualitatively and quantitatively for existing coenesthesia. They were consecutively admitted, examined, and treated in the pain outpatient clinic of the University of Magdeburg over a five-year period (2013-2017).

Of the 844 patients evaluated, 57 (6.7%) fulfilled the criteria of coenesthesia. The pain description may be rather bizarre if the patient is suffering from a psychiatric disorder, but it was also conspicuous by inappropriate localization for the pain description (tooth cramp instead of abdominal cramp). In our study, pain was mainly localized in the facial area (n = 35). Twenty-seven patients had no psychopathological abnormalities and 30 patients could be assigned an additional psychiatric diagnosis. In 23 patients, depression occurred as a psychological comorbidity.

Coenesthesia does not necessarily occur in connection or only with schizophrenia. Coenesthesia should be considered if the patient gives a bizarre description of pain, but also in common pain descriptions, such as burning, stabbing, cramping, or a feeling of pressure, if these are related to unusual locations (cramping tooth).