Sensibilidad al dolor en pacientes con esquizofrenia: una revisión sistemática y metaanálisis

• Juan P Carrasco-Picazo ^[1] ; Aurora González-Teruel ^[2] ; Ana M Gálvez-Llompart ^[1] ; Juan A Carbonell-Asins ^[3] ; Miguel Hernández-Viadel ^[1]
  1. [1] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  2. [2] Universitat de València

     Universitat de València

     Valencia, España

     
  3. [3] IRB Barcelona - Institute for Research in Biomedicine

     IRB Barcelona - Institute for Research in Biomedicine

     Barcelona, España

     

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• Localización: Actas españolas de psiquiatría, ISSN 1139-9287, Vol. 51, Nº. 1, 2023, págs. 29-40
• Idioma: español
• Títulos paralelos:
  • Pain sensitivity in patients with schizophrenia: A systematic review and meta-analysis
• Enlaces
  • Texto completo
• Resumen
  • español

    Introducción. En personas diagnosticadas de esquizofrenia se han observado alteraciones en la percepción del dolor. Algunas investigaciones sugieren la existencia de una posible hiposensibilidad, mientras que otras describen una hipersensibilidad al dolor en personas con esquizofrenia. En definitiva, los estudios presentan resultados contradictorios.

    Método. Se ha llevado a cabo una revisión sistemática de estudios experimentales y comparativos en 5 bases de datos diferentes, incluyendo aquellos estudios que evalúan el dolor inducido de manera experimental mediante métodos físicos y comparando los resultados con un grupo control sano. Posteriormente, se ha llevado a cabo un metaanálisis comparando los pacientes con esquizofrenia con los controles sanos, utilizando un modelo de efectos aleatorios.

    Resultados. Finalmente fueron seleccionados nueve estudios, con un total de 186 participantes diagnosticados de esquizofrenia y 186 controles sanos. En el metaanálisis no se observaron diferencias significativas en la comparación de análisis general entre pacientes con esquizofrenia y controles sanos. No obstante, cuando el tipo de estímulo fue estudiado por separado (mecánico, térmico o eléctrico), se observaron diferencias significativas a favor de una mayor sensibilidad al dolor en los pacientes con esquizofrenia en los estudios que evaluaron el dolor con presión mecánica o isquemia, pero no en aquellos que utilizaron métodos térmicos o eléctricos.

    Conclusiones. El resultado global de nuestra revisión sistemática no respalda la existencia de una alteración en la sensibilidad al dolor en los sujetos con esquizofrenia, aunque un análisis de subgrupos sugiere que cuando el estímulo del dolor es causado por métodos mecánicos, las personas con esquizofrenia presentan una hipersensibilidad al dolor en comparación con los controles sanos. Aunque estos resultados son datos novedosos, se requieren más estudios para replicar los resultados.

  • English

    Background. Alterations in pain perception have been observed in people diagnosed with schizophrenia. Some research suggests the existence of a possible hyposensitivity, while others describe a hypersensitivity to pain in people with schizophrenia.

    In summary, the studies present contradictory results.

    Methods. A systematic review of experimental and comparative studies has been conducted in 5 different databases, including those studies that measure pain experimentally inducing it with physical methods and that compares the results with a healthy control group. Afterwards, a meta-analysis was carried out comparing the patients with schizophrenia to the healthy controls, using the random effects model.

    Results. Nine studies were finally selected, with a total of 186 participants diagnosed with schizophrenia and 186 healthy controls. In the meta-analysis, no significative differences were observed in the general analysis. But when the type of stimuli was studied separately (mechanical, thermal,or electrical), significative differences in favor of a higher sensitivity in the patients with schizophrenia were observed in the studies that measured pain with mechanical pressure or ischemia, not in those that used thermal or electrical methods.

    Conclusions. The global result of our systematic review does not support the existence of an alteration in pain sensitivity in subjects with schizophrenia, although a subgroup analysis suggests that when pain stimulation is caused by mechanical methods, people with schizophrenia present hypersensitivity to pain compared to healthy controls. Although these results are novel data, more studies are required to replicate these results.

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