The prevalence of pain in bipolar disorder: A systematic review and large-scale meta-analysis

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 12375644 individuals (BD n=171352, n controls=12204292). The prevalence of pain in people with BD was 28.9% (95% CI=16.4-43.4%, BD n=171352). The relative risk (RR) of pain in BD compared to controls was 2.14 (95% CI=1.67-2.75%, n=12342577). The prevalence of migraine was 14.2% (95% CI=10.6-18.3%, BD n=127905), and the RR was 3.30 (95% CI=2.27-4.80%, n=6732220).About 23.7% (95% CI=13.1-36.3%, n=106214) 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.