The prevalence of pain in bipolar disorder: a systematic review and large-scale meta-analysis
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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.
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Previous research has suggested inadequate referral or lack of access to pain management services among people with pain and comorbid mental illness, particularly for those with serious mental illness.
“Previous research has sug gested an inadequate referral or lack of access to pain management services among people with pain and co morbid MI, particularly for those with SMI. 14,15”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [14]
The Introduction (p. 5) says people with serious mental illness are less likely than those without it to receive adequate care for conditions that cause pain; it also says people with bipolar disorder are less likely to seek medical help. It does not specifically establish inadequate referrals or lack of access to pain management services, or extend that finding to all people with comorbid mental illness. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPeople with SMI tend to have a high prevalence of pain, a greater number of painful conditions, but low help-seeking behaviour for their pain.
“despite people with SMI tend to have a high prevalence of pain, 14 a greater number of painful conditions, but low help-seeking behaviour for their pain. 4”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [14]
Citation 14 is attached to the high-prevalence-of-pain clause, not the later claims about painful conditions and help-seeking, which are followed by citation 4. The Summations (p. 4) report clinically relevant pain in 28.9% of people with bipolar disorder, but that finding does not establish high pain prevalence across all people with severe mental illness (SMI). (LLM, conf=0.86)
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- Authors
- Stubbs, B., Eggermont, L., Mitchell, A. J., De Hert, M., Correll, C. U., Soundy, A., Rosenbaum, S., & Vancampfort, D.
- Affiliations
- Department of Health and Social Care (GB)
- Vrije Universiteit Amsterdam (NL)
- University of Leicester (GB)
- KU Leuven - University of Leuven; Department of Neurosciences; UPC KU Leuven, campus Kortenberg; Kortenberg Belgium
- Albert Einstein College of Medicine (US)
- University of Birmingham (GB)
- The University of Sydney (AU)
- KU Leuven (BE)
- Corresponding author
- Stubbs, B.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2014-08-06
- Volume
- 131
- Issue
- 2
- Pages
- 75-88
- ISSN
- 0001-690X (ISSN-L)
- OpenAlex
- W2121982393
- Cited by
- 129
- References
- 77
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 18 · 2023: 8 · 2022: 12 · 2021: 7 · 2020: 6 · 2019: 10 · 2018: 10 · 2017: 5 · 2016: 18 · 2015: 11 · 2014: 2
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Greenwich Academic Literature Archive (University of Greenwich) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Lirias (submittedVersion, other-oa)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, pain prevalence, chronic pain, migraine, comorbidities, pain management
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bipolar Disorder, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Migraine Disorders, Pain, Sex Factors, Prevalence, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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