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Open Access Research article

Factors associated with chronic pain in patients with bipolar depression: a cross-sectional study

Inmaculada Failde1*, Maria Dueñas1, Luis Agüera-Ortíz23, Jorge A Cervilla45, Ana Gonzalez-Pinto6 and Juan A Mico78

Author Affiliations

1 Department of Preventive Medicine and Public Health, University of Cádiz, Avda Ana de Viya 52, Cádiz 11009, Spain

2 Psychiatry Department, University Hospital 12 de Octubre, Complutense University, Madrid, Spain

3 Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, University Hospital 12 de Octubre, Complutense University, Madrid, Spain

4 Department of Psychiatry, University of Granada, Granada, Spain

5 Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, Hospital Universitario San Cecilio, Granada, Spain

6 Centro de Investigación Biomédica en Red en Salud Mental - CIBERSAM, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain

7 Department of Neuroscience, Pharmacology and Psychiatry, School of Medicine, University of Cádiz, Cadiz, Spain

8 Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, University of Cádiz, Cádiz, Spain

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BMC Psychiatry 2013, 13:112  doi:10.1186/1471-244X-13-112

Published: 15 April 2013

Abstract

Background

While pain is frequently associated with unipolar depression, few studies have investigated the link between pain and bipolar depression. In the present study we estimated the prevalence and characteristics of pain among patients with bipolar depression treated by psychiatrists in their regular clinical practice. The study was designed to identify factors associated with the manifestation of pain in these patients.

Methods

Patients diagnosed with bipolar disorder (n=121) were selected to participate in a cross-sectional study in which DSM-IV-TR criteria were employed to identify depressive episodes. The patients were asked to describe any pain experienced during the study, and in the 6 weeks beforehand, by means of a Visual Analogical Scale (VAS).

Results

Over half of the bipolar depressed patients (51.2%, 95% CI: 41.9%–60.6%), and 2/3 of the female experienced concomitant pain. The pain was of moderate to severe intensity and prolonged duration, and it occurred at multiple sites, significantly limiting the patient’s everyday activities. The most important factors associated with the presence of pain were older age, sleep disorders and delayed diagnosis of bipolar disorder.

Conclusions

Chronic pain is common in bipolar depressed patients, and it is related to sleep disorders and delayed diagnosis of their disorder. More attention should be paid to study the presence of pain in bipolar depressed patients, in order to achieve more accurate diagnoses and to provide better treatment options.

Keywords:
Bipolar depression; Chronic pain