Behavioral indicators associated with experimental pain in schizophrenia or major depression: A pilot study

Abstract Background and objectives Pain is a subjective experience which is assessed verbally. However, the quality of verbal expression is often questioned and/or altered for subjects with a psychiatric disorder, thus complicating access to care and pain relief with a deny of their pain. Our aim was to search for obvious behavioral signs of pain feeling in subjects with schizophrenia (SC) or major depression (MD). Methods Sixteen MD, 17 SC, and16 disease-free participants were video-recorded during an experimental session comprised of an interview (baseline), pain test, and post-test period. Several non-verbal behavioral indicators were analyzed during the session and compared between the disease and control groups. Results Some behavioral indicators were more frequent during the pain tests than during the other periods, independently from the group. Conclusion Hetero-evaluation scales for conventional pain rating should be completed by the observation of these discreet behavioral indicators of pain during painful situations. Their observation during medical examination of painful points will ensure the feeling of pain, and avoid a deny of the pain feeling for psychiatric patients.