Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Psychiatry, pain, chronic pain, migraine, bipolar disorder, severe mental illness, GENERAL MEDICAL CONDITIONS, QUALITY-OF-LIFE, PHYSICAL ILLNESS, SUICIDE ATTEMPTS, MENTAL-ILLNESS, PRIMARY-CARE, MIGRAINE, DEPRESSION, COMORBIDITY, ASSOCIATION, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bipolar Disorder, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Migraine Disorders, Pain, Prevalence, Sex Factors, Young Adult, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, 32 Biomedical and clinical sciences, 42 Health sciences, 52 Psychology

Abstract:

Objective: To conduct a meta-analysis investigating the prevalence of pain in people with bipolar disorder (BD). Method: A systematic review and random effects meta-analysis searching major electronic databases from inception till 01/2014 in accordance with the PRISMA statement.We included articles reporting quantitative data on the prevalence of pain in people with BD with or without a healthy control group. Two independent authors conducted searches, extracted data, and completed methodological quality assessment. Results: Twenty two cross-sectional studies were included, representing 12 375 644 individuals (BD n = 171 352, n controls = 12 204 292). The prevalence of pain in people with BD was 28.9% (95% CI = 16.4– 43.4%, BD n = 171 352). The relative risk (RR) of pain in BD compared to controls was 2.14 (95% CI = 1.67–2.75%, n = 12 342 577). The prevalence of migraine was 14.2% (95% CI = 10.6–18.3%, BD n = 127 905), and the RR was 3.30 (95% CI = 2.27–4.80%, n = 6 732 220).About 23.7% (95% CI = 13.1– 36.3%, n = 106 214) of people with BD experienced chronic pain. Age, percentage of males, methodological quality, and method of BD classification did not explain the observed heterogeneity. Conclusion: People with BD experience significantly increased levels of pain (particularly chronic pain and migraine). The assessment and treatment of pain should form an integral part of the management of BD.