A Novel Anxiety and Affective Spectrum Disorder of Mind and Body—The ALPIM (Anxiety-Laxity-Pain-Immune-Mood) Syndrome: A Preliminary Report

Coplan, Jeremy D.; Singh, Deepan; Gopinath, Srinath; Mathew, Sanjay J.; Bulbena, Antonio

doi:10.1176/appi.neuropsych.14060132

Cited by 8 publications

(4 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Models including both somatic and also psychiatric/psychological characteristics are required. A first approach was made through the ALPIM spectrum proposal, which is the acronym for anxiety and the domains of its most commonly occurring comorbidities: JHS/hEDS, pain disorders, immune disorders, and mood disorders [Coplan et al, ]. The authors of this study hypothesized that the ALPIM syndrome have predictable psychiatric and medical comorbidities and found that significant associations between joint hypermobility and bipolar III, headache with bipolar II, and bipolar II with chronic fatigue syndrome.…”

Section: Literature Reviewmentioning

confidence: 99%

Psychiatric and psychological aspects in the Ehlers–Danlos syndromes

Bulbena¹,

Baeza-Velasco²,

Bulbena-Cabré³

et al. 2017

American J of Med Genetics Pt C

Self Cite

109

104

View full text Add to dashboard Cite

There is increasing amount of evidence pointing toward a high prevalence of psychiatric conditions among individuals with hypermobile type of Ehlers-Danlos syndrome (JHS/hEDS). A literature review confirms a strong association between anxiety disorders and JHSh/hEDS, and there is also limited but growing evidence that JHSh/ hEDS is also associated with depression, eating, and neuro-developmental disorders as well as alcohol and tobacco misuse. The underlying mechanisms behind this association include genetic risks, autonomic nervous system dysfunction, increased exteroceptive and interoceptive mechanisms and decreased proprioception. Recent neuroimaging studies have also shown an increase response in emotion processing brain areas which could explain the high affective reactivity seen in JHS/hEDS. Management of these patients should include psychiatric and psychological approaches, not only to relieve the clinical conditions but also to improve abilities to cope through proper drug treatment, psychotherapy, and psychological rehabilitation adequately coupled with modern physiotherapy. A multidimensional approach to this "neuroconnective phenotype" should be implemented to ensure proper assessment and to guide for more specific treatments. Future lines of research should further explore the full dimension of the psychopathology associated with JHS/hEDS to define the nature of the relationship. © 2017 Wiley Periodicals, Inc.KEY WORDS: joint hypermobility; anxiety; psychopathology; neuroconnective phenotype; hypermobile Ehlers-Danlos syndrome Professor Antonio Bulbena, M.D., M.Sc, Ph.D., is the Chair of the Department of Psychiatry at the Autonoma University of Barcelona with clinical, academic, and administrative contributions particularly in the area of psychosomatic medicine and anxiety disorders, dementia, chocolate and carbohydrates, clinical measurement in psychiatry, phobias, seasonality, and biometeorology. Has recently developed the Neuroconnective Phenotype and has published numerous books, book chapters, and scientific articles in peer-reviewed journals.Carolina Baeza-Velasco, Ph.D., is a clinical psychology at the Paris Descartes University, with important contributions in the area of psychological assessment and treatment of patients with comorbid anxiety disorders and joint hypermobility among other conditions. Has published several articles about the psychological factors of EDS and related conditions. Andrea Bulbena-Cabre, M.D., M.Sc., is a Psychiatry Research Fellow at the Icahn School of Medicine at Mount Sinai/J. J. Peters Bronx VA Hospital. She has specialized in psychosomatic medicine and is currently studying the anxiety-joint hypermobility phenomena in bipolar and psychotic spectrum disorders. Other research interests include substance abuse, especially in synthetic cannabis and psychosis.Guillem Pailhez, M.D., Ph.D., is an Assistant Professor at the Department of Psychiatry at the Autonoma University of Barcelona, has devoted his career in the study of the interactions between mind and body ...

show abstract

Section: Literature Reviewmentioning

confidence: 99%

Psychiatric and psychological aspects in the Ehlers–Danlos syndromes

Bulbena¹,

Baeza-Velasco²,

Bulbena-Cabré³

et al. 2017

American J of Med Genetics Pt C

Self Cite

109

104

View full text Add to dashboard Cite

show abstract

“…The major symptoms included cognitive impairments (attention, memory, processing speed, concentration/executive functioning), tactile hypersensitivity, sun sensitivity, orthostatic hypotension, weight loss, fatigue, non-restorative sleep, pelvic pain, difficulty urinating, headaches peripheral neuropathy, muscle atrophy, cervical radiculopathy, hair loss, costochondritis, subluxation of multiple joints, and generalized pain. After more thorough assessments, the eventual diagnosis was late stage Lyme borreliosis with multisystem symptoms, porphyria, Ehlers-Danlos/ALPIM syndrome (anxiety-laxity-pain-immune-mood) [56] with seizures caused by increased intracranial pressure from cranio-cervical instability. On closer evaluation, the patient had complex partial seizures and did not have "pseudoseizures".…”

Section: Case Presentationsmentioning

confidence: 99%

Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty

Bransfield

Friedman

2019

Healthcare

View full text Add to dashboard Cite

There is often difficulty differentiating between psychosomatic, somatopsychic, multisystem illness, and different degrees of medical uncertainty. Uncommon, complex, and multisystem diseases are commonly misdiagnosed. Two case histories are described, and relevant terms differentiating psychosomatic, somatopsychic, and multisystem illnesses are identified, reviewed, and discussed. Adequate differentiation requires an understanding of the mind/body connection, which includes knowledge of general medicine, psychiatry, and the systems linking the body and the brain. A psychiatric diagnosis cannot be given solely based upon the absence of physical, laboratory, or pathological findings. Medically unexplained symptoms, somatoform disorder, and compensation neurosis are outdated and/or inaccurate terms. The terms subjective, nonspecific, and vague can be used inaccurately. Conversion disorders, functional disorders, psychogenic illness, factitious disorder imposed upon another (Munchausen’s syndrome by proxy), somatic symptom disorder, psychogenic seizures, psychogenic pain, psychogenic fatigue, and delusional parasitosis can be over-diagnosed. Bodily distress disorder and bodily distress syndrome are scientifically unsupported and inaccurate. Many “all in your head” conditions may be related to the microbiome and the immune system. Better education concerning the interface between medicine and psychiatry and the associated diagnostic nomenclature as well as utilizing clinical judgment and thorough assessment, exercising humility, and maintaining our roots in traditional medicine will help to improve diagnostic accuracy and patient trust.

show abstract

“…[16] A relationship was determined between five potentially pathophysiologically linked domains: anxiety disorders, joint laxity, chronic pain disorders, immune dysfunction, and mood disorders. [7] A recent study exploring psychiatric and somatic phenotype of BPAD with co-morbid anxiety disorder found hypermobile joints in 41% of the sample, and it was significantly associated with somatosensory amplification. [8] The commonly used medications for these symptoms, such as antidepressants for anxiety symptoms and steroids for pain symptoms, can have a negative impact on the course of BPAD.…”

mentioning

confidence: 99%

“…7. Agopian AJ, Tinker SC, Lupo PJ, Canfield MA, Mitchell LE.…”

mentioning

confidence: 99%