Study: People with Ehlers-Danlos face increased risks for depression and other psychiatric disorders.

Published in BioMed Central July 4, 2016

Ehlers-Danlos syndrome (EDS) is the name applied to a rather large group of inherited disorders that affect the connective tissue, the tissue that provides support to many parts of the body. This genetic disorder is present in at least 1/5000 individuals [1] and an important cause of joint hypermobility syndrome [2]. The disease is characterized by hypermobility, although symptoms and signs can be highly variable and include joint complaints, myalgia, skin problems, sleep apnea, pneumothorax and cardiovascular disease. While a diagnosis of EDS can be comforting to the patient, there is no curative treatment for EDS. Instead, physicians aim to stabilize joints and prevent complications, sometimes using surgery to resolve the condition. Physiotherapy is an integral part of patient management [3].

Intense pain, diagnostic delay and risk of unemployment due to musculoskeletal complications, all contribute to the emotional burden of the disorder [4]. Already in 1994, Lumley et al. reported a link between EDS and psychological problems [5]. Despite the long-term awareness of psychosocial dysfunctioning in EDS, studies on psychiatric disorders in EDS or hypermobility syndrome are rare, but well summarized in a recent meta-analysis by Smith et al. [4]. Smith et al. found a fourfold increased risk of both anxiety and depression in hypermobility syndrome, while the risk of panic disorder was even higher (odds ratio (OR) = 6.7, 95 % confidence interval (95 % CI) 2.2–20.4). However, the OR for anxiety was based on only 253 patients with joint hypermobility and the three studies [6, 7, 8] contributing data on anxiety found substantially different risk estimates with the most recent paper reporting a lack of association but with wide CIs (OR = 0.9, 95 % CI 0.1–5.6) [7]. Examining anxiety scores, levels were higher in the 501 individuals with joint hypermobility (standardized mean difference in score: +0.5) than in the 948 controls [4].

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