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)

Abstract

<b>Background</b> 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.<p></p> <b>Methods</b> 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.<p></p> <b>Results</b> 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).<p></p> <b>Conclusions </b>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, Professor 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 > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & 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