Pain insensitivity in schizophrenia: a neglected phenomenon and some implications

The literature on insensitivity to pain in schizophrenia is reviewed. Numerous reports indicate that, relative to normals, individuals with schizophrenia are insensitive to physical pain associated with illness and injury. In addition, insensitivity to pain of various sorts administered in experimental studies has been reported frequently in this population. This extensive and diverse literature of clinical and experimental reports suggests that many individuals with schizophrenia are less sensitive to pain than normal individuals. However, because the experimental studies--almost all of which were conducted before 1980--suffer from a variety of methodological limitations, this research provides neither a satisfactory characterization nor an adequate explanation of pain insensitivity in schizophrenia. It is argued that this widely reported but currently neglected phenomenon has important implications for physical health, self-mutilation, homelessness, premorbid development, and affective flattening in individuals with schizophrenia.