Pain intensity perception reduction by mania in patients with chronic pain
Chronic pain is defined as an unpleasant sensory sensation which is associated with actual or potential tissue damage. Disorders like depression, fibromyalgia, orofacial pain, osteoarthritis are associated with chronic pain disorders. Other mood disorders such as bipolar disorders are characterized by periods of increased energy and positive affect. Bipolar disorder is associated with poor pain outcomes, but the extant literature has not taken into account.
To understand hypomania, influences of pain intensity, a study was conducted. In conducted study, a total of 201 patients of chronic pain with bipolar I (39.6%) or bipolar II (60.4%) disorder who were undergone a psychological evaluation for an interventional pain procedure. Patients who underwent a semi-structured interview, they recalled reductions in pain intensity during their most recent manic or hypomanic episodes. The proportion of patients who responded “yes” versus “no” to this question was the primary outcome variable.
A chi-square analysis was conducted to test if the patients with bipolar disorder recalled experienced reduction in pain during their most recent episodes of mania or hypomania. After analysis, result revealed that 64.2% of patients experienced a reduction in pain intensity during their most recent manic or hypomanic episode. There were no significant differences in the percentage of people with bipolar I and bipolar II disorders.
However, perceptions of reduced pain intensity during mania or hypomania that contributed to a cycle of increased activity during manic episodes, which may increase pain over time. It also led to false positive findings on spinal cord stimulated trials and diagnostic pain blocks which were among other interventional pain procedures. The preliminary findings of this study highlighted the clinical importance of assessing for bipolar disorders in patients with chronic pain.