Self-Reported Pain and Emotional Reactivity in Bipolar Disorder: A Prospective FACE-BD Study

Abstract

In patients with bipolar disorder (BD), pain prevalence is close to 30%. It is important to determine whether pain influences BD course and to identify factors associated with pain in BD in order to guide BD management. This naturalistic, prospective study used data on 880 patients with BD from the French FACE-BD cohort who were divided into two groups according to the presence or absence of pain. Multivariate models were used to test whether pain was associated with affective states and personality traits while controlling for confounders. Then, multivariate models were used to test whether pain at baseline predicted global life functioning and depressive symptomatology at one year. At baseline, 22% of patients self-reported pain. The pain was associated with depressive symptomatology, levels of emotional reactivity in a quadratic relationship, and a composite variable of personality traits (affective lability, affective intensity, hostility/anger, and impulsivity). At one year, the pain was predictive of depression and lower global life functioning. Pain worsens mental health and well-being in patients with BD. The role of emotions, depression, and personality traits in pain has to be elucidated to better understand the high prevalence of pain in BD and to promote specific therapeutic strategies for patients experiencing pain.

Keywords: affective symptoms; bipolar disorder; depression; pain.

Figure 1

Probability of reporting pain in function of the emotional reactivity and sensory perception levels. MAThys: Multidimensional Assessment of Thymic States.

Figure 2

PCA clustering of personality traits evaluated with the indicated questionnaires. AIM Affect Intensity Measure; ALS Affective Lability Scale; BDHI Buss–Durkee Hostility Inventory; BIS-10 Barratt Impulsiveness Scale.