title: Factors associated with chronic pain in patients with bipolar depression: a cross-sectional study.
abstract: BACKGROUND
  While pain is frequently associated with unipolar depression, few studies have investigated the link between pain and bipolar depression. In the present study we estimated the prevalence and characteristics of pain among patients with bipolar depression treated by psychiatrists in their regular clinical practice. The study was designed to identify factors associated with the manifestation of pain in these patients.
  
  
  METHODS
  Patients diagnosed with bipolar disorder (n=121) were selected to participate in a cross-sectional study in which DSM-IV-TR criteria were employed to identify depressive episodes. The patients were asked to describe any pain experienced during the study, and in the 6 weeks beforehand, by means of a Visual Analogical Scale (VAS).
  
  
  RESULTS
  Over half of the bipolar depressed patients (51.2%, 95% CI: 41.9%-60.6%), and 2/3 of the female experienced concomitant pain. The pain was of moderate to severe intensity and prolonged duration, and it occurred at multiple sites, significantly limiting the patient's everyday activities. The most important factors associated with the presence of pain were older age, sleep disorders and delayed diagnosis of bipolar disorder.
  
  
  CONCLUSIONS
  Chronic pain is common in bipolar depressed patients, and it is related to sleep disorders and delayed diagnosis of their disorder. More attention should be paid to study the presence of pain in bipolar depressed patients, in order to achieve more accurate diagnoses and to provide better treatment options.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Cádiz, Avda Ana de Viya 52, Cádiz 11009, Spain. inmaculada.failde@uca.es
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Failde
authors.forename: Maria
authors.initials: M
authors.lastname: Dueñas
authors.forename: Luis
authors.initials: L
authors.lastname: Agüera-Ortíz
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Cervilla
authors.forename: Ana
authors.initials: A
authors.lastname: Gonzalez-Pinto
authors.forename: Juan A
authors.initials: JA
authors.lastname: Mico
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000150:complications*; D059350:Chronic Pain / Q000150:complications*; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003863:Depression / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis