Abstract
In patients with bipolar disorder (BD), pain prevalence is close to 30%. It is important to determine whether pain influences BD course and to identify factors associated with pain in BD in order to guide BD management. This naturalistic, prospective study used data on 880 patients with BD from the French FACE-BD cohort who were divided into two groups according to the presence or absence of pain. Multivariate models were used to test whether pain was associated with affective states and personality traits while controlling for confounders. Then, multivariate models were used to test whether pain at baseline predicted global life functioning and depressive symptomatology at one year. At baseline, 22% of patients self-reported pain. The pain was associated with depressive symptomatology, levels of emotional reactivity in a quadratic relationship, and a composite variable of personality traits (affective lability, affective intensity, hostility/anger, and impulsivity). At one year, the pain was predictive of depression and lower global life functioning. Pain worsens mental health and well-being in patients with BD. The role of emotions, depression, and personality traits in pain has to be elucidated to better understand the high prevalence of pain in BD and to promote specific therapeutic strategies for patients experiencing pain.
Highlights
Bipolar disorder (BD) is one of the most debilitating disorders and is strongly associated with somatic comorbidities
Index; QIDS-SR Quick Inventory of Depressive Self-report; MAThyS Multidimensional Assessment of Thymic States; bipolar disorder (BD) Bipolar disorder. ☨ The sensory and emotional subcomponents of the MAThyS were included in the three models, but the odds ratios could not be extracted for these two variables because their relationship with pain was quadratic
Our results extend this association to patients with BD, underlining the importance of depression on pain
Summary
Bipolar disorder (BD) is one of the most debilitating disorders and is strongly associated with somatic comorbidities. High affective lability leads to more severe pain and more functional incapacity in patients with chronic pain [26,27] and is a better predictor of pain symptoms than depression or anxiety [27]. In this naturalistic, prospective study, we assessed whether pain was associated with depression, BD subtypes, and personality traits after controlling for sleep quality, somatic and psychiatric comorbidities, medication intake, sociodemographic variables, and anxiety. We investigated whether pain could be linked to five domains of BD functioning: emotional reactivity, cognitive processing speed, motivation levels, motor activity, and sensory perception intensity [28]. We tested whether pain at baseline predicted global functioning and depression level at one year
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