Pain in women with and without bipolar spectrum disorder

Amanda L Stuart ^1* Michael Berk ^1,2,3,4,5 Julie Pasco ^1,6,7,8 Mohamadreza Mohebbi ⁹ Shae Quirk ¹ Lana J Williams ¹

• ¹ IMPACT, Deakin University, Geelong, Australia
• ² Florey Institute of Neuroscience and Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
• ³ Melbourne Clinic, Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
• ⁴ Orygen, The University of Melbourne, Parkville, Victoria, Australia
• ⁵ Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
• ⁶ Department of Medicine, Western Health, The University of Melbourne, St Albans, Australia
• ⁷ Department of Preventative Medicine, Monash University, Melbourne, Australia
• ⁸ University Hospital Geelong, Geelong, Victoria, Australia
• ⁹ Biostatistics Unit, Faculty of Health, Deakin Univeristy, Geelong, Victoria, Australia

Introduction: Bipolar disorder is associated with several physical conditions and possibly increased pain, although research outside hospital settings is limited. We compared perceived pain among population-based women with and without bipolar disorder.Method: This study examined 113 women with bipolar disorder (59 euthymic, 54 symptomatic in past month) and 316 age-matched women without bipolar disorder drawn from studies located in the same region of south-eastern Australia. Mental disorders were confirmed by clinical interview (SCID-I/NP). Pain during the past week was determined by numeric rating scale (0-10, 10=pain as severe as I can imagine) and deemed present if ≥5. Demographic, lifestyle, and health information was obtained via questionnaire. Odds ratios (OR) with 95% confidence intervals for the likelihood of pain were estimated using marginal binary logistic regression models, adjusting for potential confounders. Results: Women with bipolar disorder who were euthymic at the appointment were at increased odds of headache [adjOR 3.4, 95%CI (1.4, 7.9)], back pain [2.6 (1.3, 5.4)], overall pain(s) [5.7(2.9, 11.4)], pain at ≥3 sites [2.3 (1.0, 5.2)] and were in pain ≥50% time spent awake[2.3 (1.1, 5.1)] compared to women without bipolar disorder. The pattern of association was similar but stronger for women symptomatic in the past month; headache [6.0 (2.6, 13.9)], back pain [4.2 (2.0, 8.5)], overall pain(s) [7.2(3.4, 15.4)], pain at ≥3 sites [5.1 (2.3, 11.1)] and ≥50% time in pain [4.5 (2.2, 9.3)]. Daily activity interference from pain did not differ between groups (all p>0.05).Conclusion: Women with bipolar disorder are more likely to report pain regardless of phase.Assessment and management of pain is necessary to reduce associated burden.