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Pain and rejection sensitivity in bipolar depression

Authors


  • AE has received remuneration for lectures or advisory board membership from Eli Lilly & Co, Boehringer-Ingelheim, and GlaxoSmithKline in the last five years; and has not been a member of an industry advisory board since 2008. PBM has received remuneration for lectures or advisory board membership from AstraZeneca, Eli Lilly & Co., Janssen-Cilag, or Lundbeck in the last five years; and has not been a member of an industry advisory board since late 2007. DHP has received remuneration for a lecture from Eli Lilly & Co. in the last five years. CL has received remuneration for lectures from Eli Lilly & Co. and Wyeth in the last five years. MB, AW, GR, AF, and JC have no conflicts of interest to report.

Corresponding author:
Anna Ehnvall, M.D., Ph.D.
Institute of Clinical Neuroscience
Gothenburg University
Psychiatric Outpatient Clinic
Oskarsdalsgatan 7
Varberg 43240, Sweden
Fax: +46-0340-483321
E-mail: anna.ehnvall@lthalland.se

Abstract

Ehnvall A, Mitchell PB, Hadzi-Pavlovic D, Loo C, Breakspear M, Wright A, Roberts G, Frankland A, Corry J. Pain and rejection sensitivity in bipolar depression.
Bipolar Disord 2011: 13: 59–66. © 2011 The Authors.
Journal compilation © 2011 John Wiley & Sons A/S.

Objectives:  Little is known regarding the correlates of pain in bipolar disorder. Recent neuroimaging studies support the contention that depression, as well as pain distress and rejection distress, share the same neurobiological circuits. In a recently published study, we confirmed the hypothesis that perception of increased pain during treatment-refractory depression, predominantly unipolar, was related to increased rejection sensitivity. In the present study, we aimed to test this same hypothesis for bipolar depression.

Methods:  The present study analysed data from 67 patients presenting to the Black Dog Institute Bipolar Disorders Clinic in Sydney, Australia. The patients all met DSM-IV criteria for bipolar disorder and had completed a self-report questionnaire regarding perceived pain and rejection sensitivity during depression.

Results:  A significant increase in the experience of headaches (p = 0.003) as well as chest pain (p = 0.004) during bipolar depression was predicted by a major increase in rejection sensitivity when depressed, i.e., state rejection sensitivity. Being rejection sensitive in general, i.e., trait rejection sensitivity, did not predict pain during depression.

Conclusions:  The experience of increased headaches and chest pain during bipolar depression is related to increased rejection sensitivity during depression. Research to further elucidate this relationship is required.

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