Stubbs Brendon, Mitchell Alex J, De Hert Marc, Correll Christoph U, Soundy Andy, Stroobants Marc, Vancampfort Davy
Faculty of Education and Health, University of Greenwich, Southwood Site, Avery Hill Road, Eltham, London SE9 2UG, UK.
Department of Psycho-oncology, University of Leicester, Leicester LE1 5WW, UK.
Schizophr Res. 2014 Dec;160(1-3):1-8. doi: 10.1016/j.schres.2014.10.017. Epub 2014 Nov 11.
People with schizophrenia frequently have physical comorbidities that can cause pain. Experimental studies report reduced pain sensitivity among schizophrenia patients, but it remains unclear if clinically relevant pain is less prevalent in schizophrenia.
We systematically searched major electronic databases from inception till 03/2014. Articles were included that reported the prevalence of clinical pain in people with schizophrenia. Two independent authors conducted searches, completed methodological quality assessment and extracted data. A random effects relative risks (RR) meta-analysis was conducted to determine the prevalence of all-cause and specific pain in schizophrenia, and the relative prevalence compared to the general population, and to assess moderators.
Altogether, 14 studies were included encompassing 242,703 individuals with schizophrenia (30.2-55.8 years) and 4,259,221 controls. Different types of pain were considered. The overall pooled prevalence of clinical pain in people with schizophrenia was 34.7% (95% CI=23.6-46.6). In the comparative analysis involving 7 studies with controls, the RR was 0.99 (95% CI=0.83-1.19). The pooled prevalence of headache among 94,043 individuals with schizophrenia was 29.9% (95% CI=3-69%) and the RR compared to 4,248,284 controls was 1.32 (95% CI=0.85-2.07). In moderator analyses, neither age, sex, study quality or pain assessment method influenced pain prevalence.
Clinical pain affects a third of people with schizophrenia and levels are similar with age- and sex-comparable controls. Future research is needed to determine if similar clinical pain prevalences in schizophrenia occur despite having more painful conditions, resulting from under-reporting, higher pain thresholds or lower help seeking behaviours.
精神分裂症患者常伴有可导致疼痛的躯体共病。实验研究报告称精神分裂症患者的疼痛敏感性降低，但尚不清楚临床上相关疼痛在精神分裂症中是否不那么普遍。
我们系统检索了各大电子数据库，从建库至2014年3月。纳入报告精神分裂症患者临床疼痛患病率的文章。由两名独立作者进行检索、完成方法学质量评估并提取数据。进行随机效应相对风险（RR）荟萃分析，以确定精神分裂症中全因性疼痛和特定疼痛的患病率、与普通人群相比的相对患病率，并评估调节因素。
共纳入14项研究，涉及242,703例精神分裂症患者（年龄30.2 - 55.8岁）和4,259,221例对照。考虑了不同类型的疼痛。精神分裂症患者临床疼痛的总体合并患病率为34.7%（95%置信区间=23.6 - 46.6）。在涉及7项有对照研究的比较分析中，RR为0.99（95%置信区间=0.83 - 1.19）。94,043例精神分裂症患者中头痛的合并患病率为29.9%（95%置信区间=3 - 69%），与4,248,284例对照相比的RR为1.32（95%置信区间=0.85 - 2.07）。在调节因素分析中，年龄、性别、研究质量或疼痛评估方法均未影响疼痛患病率。
临床疼痛影响三分之一的精神分裂症患者，且与年龄和性别匹配的对照者水平相似。未来需要开展研究，以确定尽管精神分裂症患者存在更多疼痛性疾病，但由于报告不足、疼痛阈值较高或求助行为较少，其临床疼痛患病率是否仍相似。
