Risch Nathan, Dubois Jonathan, M'bailara Katia, Cussac Irena, Etain Bruno, Belzeaux Raoul, Dubertret Caroline, Haffen Emmanuel, Schwan Raymund, Samalin Ludovic, Roux Paul, Polosan Mircea, Leboyer Marion, Courtet Philippe, Olié Emilie
Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France.
Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France.
J Clin Med. 2022 Feb 8;11(3):893. doi: 10.3390/jcm11030893.
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.
在双相情感障碍(BD)患者中,疼痛发生率接近30%。确定疼痛是否会影响BD病程以及识别与BD疼痛相关的因素对于指导BD的管理非常重要。这项自然主义的前瞻性研究使用了来自法国FACE-BD队列的880名BD患者的数据,这些患者根据是否存在疼痛被分为两组。多变量模型用于在控制混杂因素的同时,测试疼痛是否与情感状态和人格特质相关。然后,使用多变量模型测试基线时的疼痛是否能预测一年后的整体生活功能和抑郁症状。在基线时,22%的患者自我报告有疼痛。疼痛与抑郁症状、呈二次关系的情绪反应水平以及人格特质的复合变量(情感不稳定性、情感强度、敌意/愤怒和冲动性)相关。在一年时,疼痛可预测抑郁和较低的整体生活功能。疼痛会恶化BD患者的心理健康和幸福感。必须阐明情绪、抑郁和人格特质在疼痛中的作用,以便更好地理解BD中疼痛的高发生率,并为经历疼痛的患者推广特定的治疗策略。