1/3. Pain insensitivity in schizophrenia. Case report and review of the literature.We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illnesses in which pain is characteristically a prominent presenting symptom. While research into the cause of altered pain perception in psychotic patients is continuing, clinicians should maintain a high index of suspicion of serious medical illness when evaluating such patients.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
2/3. Acute surgical abdominal disease in chronic schizophrenic patients: a unique clinical problem.From our experience with chronic schizophrenic patients treated for acute intra-abdominal surgical disease, we present seven examples of this unique clinical condition. In all seven cases the decision to operate was preceded by considerable delay, owing to misleading medical history, patient behavior, and the lack of definitive signs of peritonitis. The intra-operative findings were unexpected, and in all cases the disease had reached an advanced stage. As chronic schizophrenic patients have a distorted perception of pain and seldom demonstrate a clinical picture commensurate with the disease, we advocate that a higher index of suspicion be assigned to these patients than to the average acutely ill patient.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
3/3. Pain insensitivity in schizophrenic patients. A surgical dilemma.Some schizophrenic patients have decreased pain perception while others have decreased pain expression. These factors frequently lead to difficulties in the diagnosis of acute intra-abdominal surgical emergencies. Increasingly large numbers of schizophrenic patients are being cared for in the community. It is therefore imperative that surgeons be acutely aware of the diagnostic dilemmas presented by this group of patients so that misdiagnosis is avoided and appropriate surgical therapy is instituted in a timely manner.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |