Hypothesis: bipolar illness with complaints of chronic musculoskeletal pain is a form of pseudofibromyalgia.
OBJECTIVE
To present a hypothesis accounting for the differential response of bipolar patients diagnosed with fibromyalgia (FM) to standard therapies, taking into account the markedly statistically significant increase of its prevalence in the syndrome.


METHODS
All articles relating to the heading bipolar illness AND fibromyalgia as well as bipolar illness AND pain were searched using PubMed and Medline since 1966. The prevalence of bipolar illness in our last 100 FM consultations was reviewed.


RESULTS
Ten percent of our 100 most recent FM consultations included patients with an established diagnosis of bipolar illness. They had little if no response to traditional FM interventions and appeared to have vague and uncertain tender point examinations.


CONCLUSIONS
Bipolar illness may be associated with a form of chronic musculoskeletal pain complaints that is not FM. Studies into the role that neurotransmitters play in bipolar patients with complaints of musculoskeletal discomfort deserve further exploration.
Wallace
Daniel J
DJ
Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. dwallace@ucla.edu
Gotto
Jennifer
J
D001714:Bipolar Disorder / Q000453:epidemiology*; D003951:Diagnostic Errors; D005356:Fibromyalgia / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence