ArticleBMC psychiatry2020
Chronic pain diagnoses and opioid dispensings among insured individuals with serious mental illness.
Article in BMC psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Chronic pain in mental disorders: An umbrella review of the prevalence, risk factors, and treatments across 957,168 people with mental disorders and 16,606,910 controls.European psychiatry : the journal of the Association of European Psychiatrists · 2025Pooled it
- Cross-Sectional Associations Among Symptoms of Pain, Irritability, and Depression and How These Symptoms Relate to Social Functioning and Quality of Life: Findings From the EMBARC and STRIDE Studies and the VitalSign6 Project.The Journal of clinical psychiatry · 2021Trial
- Diagnostic sequence of chronic pain and severe mental illness: Relationship with mental health and hospitalization outcomes.British journal of pain · 2026Article
- Are there inequities in the assessment or management of pain for people with severe mental illness living with life-threatening diseases? A mixed-methods systematic review.Palliative care and social practice · 2026Review
- Preexisting Psychiatric Risk Factors and Any and Long-Term Opioid Use in Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
- Patterns of shared genetic risk between chronic pain, psychopathologies, and neuroticism.Clinical psychological science : a journal of the Association for Psychological Science · 2025Article
- Genome-Wide Association Study of Treatment-Resistant Depression: Shared Biology With Metabolic Traits.The American journal of psychiatry · 2024Article
- Prescription opioid dispensing patterns among patients with schizophrenia or bipolar disorder.BMC psychiatry · 2024Observational
- Pain intensity, physical function, and depressive symptoms associated with discontinuing long-term opioid therapy in older adults with Alzheimer's disease and related dementias.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Global trends and hotspots in pain associated with bipolar disorder in the last 20 years: a bibliometric analysis.Frontiers in neurology · 2024Article
- Association between waist circumference and chronic pain: insights from observational study and two-sample Mendelian randomization.Frontiers in nutrition · 2024Article
- Barriers to accessing pain management services among veterans with bipolar disorder.Health services research · 2023Article
- Determining the Impact of Opioid Policy on Substance Use and Mental Health-Related Harms: Protocol for a Data Linkage Study.JMIR research protocols · 2023Article
- Psychiatric risk factors for chronic high-dose opioid prescribing: register-based cohort study.BJPsych open · 2023Article
- Prevalence and treatment of neuropathic pain diagnoses among U.S. nursing home residents.Pain · 2022Article
- Risk of Overdose Associated With Co-prescription of Antipsychotics and Opioids: A Population-Based Cohort Study.Schizophrenia bulletin · 2022Article
- The relationship between patients' income and education and their access to pharmacological chronic pain management: A scoping review.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
- Geographic Variation in the Use of Gabapentinoids and Opioids for Pain in a Commercially Insured Adult Population in the United States.Journal of pain research · 2022Article
- Outpatient prescribing of opioids to adults diagnosed with mental disorders in the United States.Drug and alcohol dependence · 2021Article
- Chronic Pain and Psychiatric Conditions.Complex psychiatryReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundIndividuals with major depressive disorder (MDD) and bipolar disorder (BD) have particularly high rates of chronic non-cancer pain (CNCP) and are also more likely to receive prescription opioids for their pain. However, there have been no known studies published to date that have examined opioid treatment patterns among individuals with schizophrenia.
methodsUsing electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of MDD (N = 65,750), BD (N = 38,117) or schizophrenia or schizoaffective disorder (N = 12,916) were identified and matched on age, sex and Medicare status to controls with no documented mental illness. CNCP diagnoses and prescription opioid medication dispensings were extracted for the matched samples. Multivariate analyses were conducted to evaluate (1) the odds of receiving a pain-related diagnosis and (2) the odds of receiving opioids, by separate mental illness diagnosis category compared with matched controls, controlling for age, sex, Medicare status, race/ethnicity, income, medical comorbidities, healthcare utilization and chronic pain diagnoses.
resultsMultivariable models indicated that having a MDD (OR = 1.90; 95% CI = 1.85-1.95) or BD (OR = 1.71; 95% CI = 1.66-1.77) diagnosis was associated with increased odds of a CNCP diagnosis after controlling for age, sex, race, income, medical comorbidities and healthcare utilization. By contrast, having a schizophrenia diagnosis was associated with decreased odds of receiving a chronic pain diagnosis (OR = 0.86; 95% CI = 0.82-0.90). Having a MDD (OR = 2.59; 95% CI = 2.44-2.75) or BD (OR = 2.12; 95% CI = 1.97-2.28) diagnosis was associated with increased odds of receiving chronic opioid medications, even after controlling for age, sex, race, income, medical comorbidities, healthcare utilization and chronic pain diagnosis; having a schizophrenia diagnosis was not associated with receiving chronic opioid medications.
conclusionsIndividuals with serious mental illness, who are most at risk for developing opioid-related problems, continue to be prescribed opioids more often than their peers without mental illness. Mental health clinicians may be particularly well-suited to lead pain assessment and management efforts for these patients. Future research is needed to evaluate the effectiveness of involving mental health clinicians in these efforts.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.