Chronic multisite pain in major depression and bipolar disorder: cross-sectional study of 149,611 participants in UK Biobank

Nicholl, B. I. et al. (2014) Chronic multisite pain in major depression and bipolar disorder: cross-sectional study of 149,611 participants in UK Biobank. BMC Psychiatry, 14, 350. (doi:10.1186/s12888-014-0350-4) (PMID:25490859) (PMCID:PMC4297369)

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Publisher's URL: http://www.biomedcentral.com/1471-244X/14/350

Abstract

Background Chronic pain has a strong association with major depressive disorder (MDD), but there is a relative paucity of studies on the association between chronic multisite pain and bipolar disorder (BD). Such studies are required to help elucidate the complex biological and psychological overlap between pain and mood disorders. The aim of this study is to investigate the relationship between chronic multisite pain and mood disorder across the unipolar-bipolar spectrum.

Methods We conducted a cross-sectional study of 149,611 UK Biobank participants. Self-reported depressive and bipolar features were used to categorise participants into MDD and BD groups and a non-mood disordered comparison group. Multinomial logistic regression was used to establish whether there was an association between extent of chronic pain (independent variable) and mood disorder category (dependent variable), using no pain as the referent category, and adjusting for a wide range of potential sociodemographic, lifestyle and comorbidity confounders.

Results Multisite pain was significantly more prevalent in participants with BD and MDD, for example, 4-7 pain sites: BD 5.8%, MDD 4.5%, and comparison group 1.8% (p≥0.001). A relationship was observed between extent of chronic pain and risk of BD and persisted after adjusting for confounders (relative to individuals with no chronic pain): 2-3 sites RRR of BD 1.84 (95% CI 1.61, 2.11); 4-7 sites RRR of BD 2.39 (95%CI 1.88, 3.03) and widespread pain RRR of BD 2.37 (95%CI 1.73, 3.23). A similar relationship was observed between chronic pain and MDD: 2-3 sites RRR of MDD 1.59 (95%CI 1.54, 1.65); 4?7 sites RRR of MDD 2.13 (95%CI 1.98, 2.30); widespread pain RRR of MDD 1.86 (95%CI 1.66, 2.08).

Conclusions Individuals who report chronic pain and multiple sites of pain are more likely to have MDD and are at higher risk of BD. These findings highlight an important aspect of comorbidity in MDD and BD and may have implications for understanding the shared neurobiology of chronic pain and mood disorders.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Martin, Dr Daniel and Smith, Professor Daniel and Nicholl, Dr Barbara and Gallagher, Prof John and Evans, Professor Jonathan and Cullen, Dr Breda and Mackay, Dr Daniel and Mair, Professor Frances and Pell, Professor Jill
Authors: Nicholl, B. I., Mackay, D., Cullen, B., Martin, D. J., Ul-Haq, Z., Mair, F. S., Evans, J., McIntosh, A. M., Gallagher, J., Roberts, B., Deary, I., Pell, J. P., and Smith, D. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:BMC Psychiatry
Publisher:BioMed Central
ISSN:1471-244X
ISSN (Online):1471-244X
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in BMC Psychiatry 14(350)
Publisher Policy:Reproduced under a Creative Commons License

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