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22-04-2013 | Mental health | Article

Pain common in depressed bipolar patients


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medwireNews: Results from a Spanish study suggest that chronic pain is common among patients with bipolar disorder (BD) who are experiencing an episode of depression.

Inmaculada Failde (University of Cádiz) and colleagues found that more than half of 121 depressed BD patients reported experiencing pain, which was often of long duration and of moderate-to-severe intensity.

The participants (62.2% women) were aged 18 years or older (mean age 50.7 years) and were receiving treatment at a number of Mental Health Care Centres across Spain. The mean number of previous depressive episodes was 4.28 and the median duration of the current depressive episode was 7 months.

All of the participants were interviewed about the presence of pain during their current depressive episode, and were asked to rate the intensity of any reported pain on a visual analogue scale (VAS) of 0-100, with 0 representing no pain and 100 the worst pain possible.

A VAS of 0-100 was also used to assess the impact of pain on the patients' everyday activities, with a score of 0 representing no impact and 100 representing total incapacity.

Overall, 51.2% of patients reported significant pain (VAS >40), which was more common among women than men, at 66.1% versus 33.9%, and among those aged 40 years or older than younger patients, at 62.0% versus 38.1%.

The mean intensity of pain on the VAS was 67.5 and the average duration of pain was 68.9 months. The most common location of pain was the back (74.2%), followed by the limbs (67.7%), the head and neck (both 66.1%), and the joints (64.5%).

The pain experienced by the patients had a significant negative effect on their daily activities, at a mean VAS score of 67.7.

After accounting for gender, age, depression severity, and other variables, the team found that factors most commonly associated with pain included older age, the presence of sleep disorders, being separated or divorced, and having a prior diagnosis of other types of depression (delayed diagnosis of bipolar disorder).

Failde et al conclude in BMC Psychiatry: "We found a high prevalence of moderate to severe intensity pain in bipolar patients, which is persistent and significantly affects the patients' ability to carry out everyday activities."

They add: "We propose that greater attention should be paid to the presence of pain in bipolar patients, as well as to other factors that could influence their clinical development, such as sleep disorders and the presence of other forms of depression."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Mark Cowen, Senior medwireNews Reporter

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