The Association between Affectivity, Perceived Stress and Pain in Patients with Bipolar DisorderKarling P1*, Maripuu M2, Wikgren M2, Adolfsson R2 and Norrback KF2
- *Corresponding Author:
- Pontus Karling
Department of Public Health and Clinical Medicine, Division of Medicine/Gastroenterology
University Hospital of Umea, SE-90185 Umea, Sweden
E-mail: [email protected]
Received date: May 17, 2016; Accepted date: August 16, 2016; Published date: August 19, 2016
Citation: Karling P, Maripuu M, Wikgren M, Adolfsson R, Norrback KF (2016) The Association between Affectivity, Perceived Stress and Pain in Patients with Bipolar Disorder. J Depress Anxiety 5:244. doi: 10.4172/2167-1044.1000244
Copyright: © 2016 Karling P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Patients with bipolar disorder commonly experience recurrent/chronic pain, usually associated with worsening of the psychic state. The primary aim of the study was to evaluate the association to state anxiety, depression, perceived stress and concurrent pain. A secondary aim was to determine the locations and characteristics of pain.
Method: A cross-sectional study was conducted on 87 bipolar type 1 and 50 bipolar type 2 patients (mean age 50.4 years; 63% women). HADS-A and HADS-D was used to determine the levels of anxiety and depression, the Perceived Stress Questionnaire (PSQ) was used to measure the perception of stress, and experience of pain was determined using a validated pain questionnaire including the duration, characteristics and location of pain.
Results: Eighty-six patients (63%) reported pain, and all but 5 of these had chronic pain (≥ 3 months). Patients with pain scored significantly higher on anxiety, depression and perceived stress, and significantly lower on well being than patients with no pain. In a logistic regression using different pain locations as the dependent variables and age, gender, HADS-D, HADS-A and PSQ index score as covariates, female gender was found to be significantly associated with abdominal pain (adjusted OR 4.59; CI: 1.09-19.2), thoracic spine pain (adjusted OR 4.32; CI: 1.37-14.3), shoulder pain (adjusted OR 3.39; CI: 1.17-4.39) and ≥3 pain locations (adjusted OR 2.55; CI: 1.06-6.13. In both males and females the experience of stress was significantly associated with the presence of any pain (adjusted OR 5.56; CI: 1.61-19.2), hip pain (adjusted OR 5.52; CI 1.41-21.7) and neck pain (adjusted OR 3.37; CI: 1.10-10.3). Finally, depressive mood is significantly associated with abdominal pain (adjusted OR 12.1; CI: 2.18-67.9) and knee pain (adjusted OR 5.90; CI:1.47-23.6).
Conclusions: In patients with bipolar disorder the experience of stress and depressive mood, but not level of anxiety, is strongly related to pain.