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Article Dans Une Revue European Psychiatry Année : 2023

Subjects suffering from bipolar disorder taking lithium are less likely to report physical pain: a FACE-BD study

Nathan Risch (1, 2) , Jonathan Dubois (1, 2) , Bruno Etain (3, 4, 5) , Bruno Aouizerate (3, 6, 7) , Frank Bellivier (4, 5, 3) , Raoul Belzeaux (2, 8, 3) , Caroline Dubertret (3, 9, 10) , Emmanuel Haffen (11, 3, 12) , Dominique Januel (13, 3, 14) , Marion Leboyer (3, 15, 16) , Antoine Lefrere (8, 3, 17) , Ludovic Samalin (3, 18, 19) , Mircea Polosan (3, 20, 21) , Romain Rey (3, 22, 23) , Paul Roux (24, 3) , Raymund Schwan (3, 25, 26) , Michel Walter (27, 3) , Philippe Courtet (1, 2, 3) , Emilie Olié (2, 1, 3)
1 IGF - Institut de Génomique Fonctionnelle
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 Fondation FondaMental [Créteil]
4 Hôpital Lariboisière-Fernand-Widal [APHP]
5 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie
6 Centre hospitalier Charles Perrens [Bordeaux]
7 NutriNeuro - Nutrition et Neurobiologie intégrée
8 INT - Institut de Neurosciences de la Timone
9 Hôpital Louis Mourier - AP-HP [Colombes]
10 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
11 NEURO - Laboratoire de Neurosciences Intégratives et Cliniques - UFC (UR 481)
12 Inserm CIC 1431 - Centre d'Investigation Clinique de Besançon
13 EPS - Etablissement public de santé de Ville-Evrard
14 Université Sorbonne Paris Nord
15 Hôpital Henri Mondor
16 IMRB - Institut Mondor de Recherche Biomédicale
17 Hôpitaux Sud - Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM]
18 IP - Institut Pascal
19 CHU Clermont-Ferrand
20 GIN - [GIN] Grenoble Institut des Neurosciences
21 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
22 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
23 Centre Hospitalier le Vinatier [Bron]
24 CESP - Centre de recherche en épidémiologie et santé des populations
25 CPN - Centre Psychothérapique de Nancy [Laxou]
26 IADI - Imagerie Adaptative Diagnostique et Interventionnelle
27 CHU - BREST - Hopital de Bohars - CHRU Brest

Résumé

Introduction: Physical pain is a common issue in people with bipolar disorder (BD). It worsens mental health and quality of life, negatively impacts treatment response, and increases the risk of suicide. Lithium, which is prescribed in BD as mood stabilizer, has shown promising effects on pain. Methods: This naturalistic study included 760 subjects with BD (French FACE-BD cohort) divided in two groups: with and without self-reported pain (evaluated with the EQ-5D-5L questionnaire). In this sample, 176 subjects were treated with lithium salts. The objectives of the study were to determine whether patients receiving lithium reported less pain, and whether this effect was associated with the recommended mood stabilizing blood concentration of lithium. Results: Subjects with lithium intake were less likely to report pain (OR = 0.59, 95% CI [0.35-0.95]; p = 0.036) after controlling for sociodemographic variables, BD type, lifetime history of psychiatric disorders, suicide attempt, personality traits, current depression and anxiety levels, sleep quality, and psychomotor activity. Subjects taking lithium were even less likely to report pain when lithium concentration in blood was ≥0.5mmol/l (OR = 0.44, 95% CI [0.24-0.79]; p = 0.008). Discussion: This is the first naturalistic study to show lithium promising effect on pain in subjects suffering from BD after controlling for many confounding variables. This analgesic effect seems independent of BD severity and comorbid conditions. Randomized controlled trials are needed to confirm the analgesic effect of lithium salts and to determine whether lithium decreases pain in other vulnerable populations, such as people with chronic pain.

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Dates et versions

hal-04343891 , version 1 (14-12-2023)

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Nathan Risch, Jonathan Dubois, Bruno Etain, Bruno Aouizerate, Frank Bellivier, et al.. Subjects suffering from bipolar disorder taking lithium are less likely to report physical pain: a FACE-BD study. European Psychiatry, 2023, 67 (1), pp.e1-e8. ⟨10.1192/j.eurpsy.2023.2476⟩. ⟨hal-04343891⟩
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