The prevalence of pain in people with bipolar disorder: A systematic review and meta-analysis

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 12 375 644 individuals (BD n = 171 352, n controls = 12 204 292). The prevalence of pain in people with BD was 28.9% (95% CI = 16.4– 43.4%, BD n = 171 352). The relative risk (RR) of pain in BD compared to controls was 2.14 (95% CI = 1.67–2.75%, n = 12 342 577). The prevalence of migraine was 14.2% (95% CI = 10.6–18.3%, BD n = 127 905), and the RR was 3.30 (95% CI = 2.27–4.80%, n = 6 732 220).About 23.7% (95% CI = 13.1– 36.3%, n = 106 214) 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.status: publishe