Self-reported pain in patients with schizophrenia. Results from the national first-step FACE-SZ cohort.
Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2018-07-01; 85: 62-68
DOI: 10.1016/j.pnpbp.2018.04.007
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1. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jul 13;85:62-68. doi:
10.1016/j.pnpbp.2018.04.007. Epub 2018 Apr 17.
Self-reported pain in patients with schizophrenia. Results from the national
first-step FACE-SZ cohort.
Fond G(1), Boyer L(2), Andrianarisoa M(3), Godin O(4), Bulzacka E(3), Berna
F(5), Brunel L(3), Coulon N(3), Aouizerate B(6), Capdevielle D(7), Chereau I(8),
D’amato T(9), Denizot H(8), Dubertret C(10), Dubreucq J(11), Faget C(12),
Leignier S(11), Mallet J(10), Misdrahi D(13), Rey R(9), Lancon C(12), Passerieux
C(14), Schandrin A(7), Urbach M(14), Vidailhet P(5), Leboyer M(3), Schurhoff
F(3), Llorca PM(8); FACE-SZ (FondaMental Academic Centers of Expertise for
Schizophrenia) group.
Author information:
(1)Fondation FondaMental, Créteil, France; Aix-Marseille Univ, School of
MEDICINE – La Timone Medical Campus, EA 3279: CEReSS – Health Service Research
and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France.
Electronic address: .
(2)Fondation FondaMental, Créteil, France; Aix-Marseille Univ, School of
MEDICINE – La Timone Medical Campus, EA 3279: CEReSS – Health Service Research
and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France.
(3)Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry
Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des
Hôpitaux Universitaires H Mondor, Créteil, France.
(4)Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris
06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique,
F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie
et de Santé Publique, F-75013 Paris, France.
(5)Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de
Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine
Translationnelle de Strasbourg, Strasbourg, France.
(6)Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens,
Université de Bordeaux, F-33076 Bordeaux, France; Inserm, Neurocentre Magendie,
Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France.
(7)Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie
Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1,
Inserm, 1061, Montpellier, France.
(8)Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de
Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France.
(9)Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1,
Centre Hospitalier Le Vinatier, Pole Est, BP 300 39-95 bd Pinel, 69678 Bron
Cedex, France.
(10)Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry,
Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot,
Sorbonne Paris Cité, Faculté de médecine, France.
(11)Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation
Psychosociale, CH Alpes Isère, Grenoble, France.
(12)Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de
Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France.
(13)Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens,
Université de Bordeaux, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France.
(14)Fondation FondaMental, Créteil, France; Service de psychiatrie d’adulte,
Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil,
Université Versailles Saint-Quentin en Yvelines, Versailles, France.
INTRODUCTION: Little is known about perception of physical pain in schizophrenia
(SZ). Some studies have suggested that patients with SZ may have an increased
pain threshold, while others have suggested that patients with SZ may suffer
from undetected and untreated high physical pain levels. The objectives of this
study were (i) to investigate the prevalence of self-reported physical pain in
stabilized SZ subjects, and (ii) to determine whether physical pain was
associated with psychiatric characteristics and somatic comorbidities (iii) to
determine whether antidepressants and benzodiazepine administration were
associated with lower self-reported pain.
METHOD: 468 community-dwelling stable SZ subjects (73% men, mean aged 32 years)
were recruited in the Schizophrenia Expert Center national network. Patients
with moderate to extreme pain, assessed with the EQ5D-5L questionnaire, were
classified as belonging to the “pain group”.
RESULTS: 104 (22.2%) reported moderate to extreme pain levels. In multivariate
analysis, pain has been associated with headache (OR = 2.63 [1.04-6.63],
p = 0.04), higher anxiety (OR = 1.61 [1.18-2.21], p = 0.003), higher current
depressive symptoms (OR = 1.09 [1.01-1.17], p = 0.03), history of childhood
trauma (1.03 [1.01-1.06], p = 0.01) and older age (OR = 1.04 [1.01-1.07],
p = 0.03), independently of current psychotic severity, sociodemographic
variables, antipsychotic, antidepressant and benzodiazepine treatments. No
association with addictive behaviors or illness characteristics has been found.
CONCLUSION: The present findings suggest that community-dwelling SZ outpatients
report a high rate of self-reported physical pain, associated with headache,
depression and anxiety and history of childhood trauma. Physical pain should be
systematically assessed and specifically treated, when needed, in patients with
SZ.
Copyright © 2018 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.pnpbp.2018.04.007
PMID: 29678770 [Indexed for MEDLINE]