Association between Psychopathological Factors and Joint Hypermobility Syndrome in a Group of Undergraduates from a French University

Baeza-Velasco, Carolina; Gély-Nargeot, Marie Christine; Vilarrasa, Antonio Bulbena; Fénétrier, Caroline; Bravo, J. L.

doi:10.2190/pm.41.2.g

Cited by 40 publications

(27 citation statements)

References 22 publications

(37 reference statements)

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“…In a recent study using the Hospital Anxiety and Depression Scale, female participants with JHS had higher scores in depression than women without JHS [34]. In addition, the experience of chronic pain has been widely associated with depression [33].…”

Section: Psychopathological Factors Associated With Jhsmentioning

confidence: 99%

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Joint hypermobility syndrome: problems that require psychological intervention

et al. 2011

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Joint hypermobility syndrome (JHS), also known as Ehlers-Danlos III, is an inherited disorder of connective tissue, characterised by an exceptional increase in the joint's mobility and the presence of musculoskeletal and other symptoms. It is a benign syndrome if compared with the other types of Ehlers-Danlos, but it can become disabling particularly because it is a significant source of pain and distress. The purpose of this work is to describe some common problems in JHS that render psychological intervention in their overall management relevant. Chronic pain, associated psychopathological factors such as anxiety, depression and somatosensory amplification, and problems arising from a lack of recognition and knowledge of the syndrome, are frequent among those affected, having a negative impact on their quality of life. We emphasise the relevance of addressing JHS from a biopsychosocial approach.

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Section: Psychopathological Factors Associated With Jhsmentioning

confidence: 99%

“…Results from a study with undergraduates in France (N = 365) show that scores of somatosensory ampliWcation were higher among participants with JHS independent of gender [34], i.e. they have a signiWcantly greater tendency to amplify somatic sensations interpreting them as intense, noxious and disturbing.…”

Section: Psychopathological Factors Associated With Jhsmentioning

confidence: 99%

Joint hypermobility syndrome: problems that require psychological intervention

et al. 2011

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“…Whereas tenascin X sequence variations affect cardiovascular tissue leading to valvular disease, 50 the hypothesis that impaired integrity of vascular connective tissue leads to impaired venous return and secondary orthostatic tachycardia has not yet been convincingly tested. EDS III is also characterized by early onset of chronic pain, particularly in the shoulders, hands, and knees, 51 which may be disabling due to associated anxiety, depression, and a somatosensory amplification state 52 ; this may lead to secondary hypersympathetic responses triggered by fear of pain on standing.…”

Section: Visceral Pain and Dysmotilitymentioning

confidence: 99%

Postural Tachycardia Syndrome: A Heterogeneous and Multifactorial Disorder

Benarroch

2012

Mayo Clinic Proceedings

306

354

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Postural tachycardia syndrome (POTS) is defined by a heart rate increment of 30 beats/min or more within 10 minutes of standing or head-up tilt in the absence of orthostatic hypotension; the standing heart rate is often 120 beats/min or higher. POTS manifests with symptoms of cerebral hypoperfusion and excessive sympathoexcitation. The pathophysiology of POTS is heterogeneous and includes impaired sympathetically mediated vasoconstriction, excessive sympathetic drive, volume dysregulation, and deconditioning. POTS is frequently included in the differential diagnosis of chronic unexplained symptoms, such as inappropriate sinus tachycardia, chronic fatigue, chronic dizziness, or unexplained spells in otherwise healthy young individuals. Many patients with POTS also report symptoms not attributable to orthostatic intolerance, including those of functional gastrointestinal or bladder disorders, chronic headache, fibromyalgia, and sleep disturbances. In many of these cases, cognitive and behavioral factors, somatic hypervigilance associated with anxiety, depression, and behavioral amplification contribute to symptom chronicity. The aims of evaluation in patients with POTS are to exclude cardiac causes of inappropriate tachycardia; elucidate, if possible, the most likely pathophysiologic basis of postural intolerance; assess for the presence of treatable autonomic neuropathies; exclude endocrine causes of a hyperadrenergic state; evaluate for cardiovascular deconditioning; and determine the contribution of emotional and behavioral factors to the patient's symptoms. Management of POTS includes avoidance of precipitating factors, volume expansion, physical countermaneuvers, exercise training, pharmacotherapy (fludrocortisone, midodrine, ␤-blockers, and/or pyridostigmine), and behavioral-cognitive therapy. A literature search of PubMed for articles published from January 1, 1990, to June 15, 2012, was performed using the following terms (or combination of terms): POTS; postural tachycardia syndrome, orthostatic; orthostatic; syncope; sympathetic; baroreceptors; vestibulosympathetic; hypovolemia; visceral pain; chronic fatigue; deconditioning; headache; Chiari malformation; Ehlers-Danlos; emotion; amygdala; insula; anterior cingulate; periaqueductal gray; fludrocortisone; midodrine; propranolol; ␤-adrenergic; and pyridostigmine. Studies were limited to those published in English. Other articles were identified from bibliographies of the retrieved articles. 1,2 According to current criteria for adults, 3 POTS is defined by a heart rate increment of 30 beats/min or more within 10 minutes of standing or head-up tilt (HUT) in the absence of orthostatic hypotension; the standing heart rate is often 120 beats/min or higher. These criteria may not be applicable for individuals with low resting heart rate. For individuals aged 12 to 19 years, the required increment is at least 40 beats/min.3 The orthostatic tachycardia may be accompanied by symptoms of cerebral hypoperfusion and sympathetic hyperactivity that are reliev...

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“…In fact, the scarcity of descriptive manifestations of JHS/EDS-HT in the medical literature lays on the actual lack of shared knowledge and general unawareness of the practitioners on the multifaceted manifestations of JHS/EDS-HT. The conundrum is further complicated by the increasing number of studies highlighting (generalized) JHM as a possible predisposing factor and/or noncasually associated features for a series of extra-articular disorders (Table 4) [38–64]. At the moment, whether these complaints belong to the wider picture of the JHS/EDS-HT or rather represent nonsyndromic associations needs further investigations.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Interestingly, access to psychiatric services was registered in ~2/3 patients. A considerable excess of emotional symptoms [111] and psychological distress and somatosensory amplification [38] are noted in JHS/EDS-HT patients. More specifically, JHS/EDS-HT is more common among patients suffering from anxiety and panic disorders and, in turn, these complaints are frequently reported in JHS/EDS-HT [112, 113].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Ehlers-Danlos Syndrome, Hypermobility Type: An Underdiagnosed Hereditary Connective Tissue Disorder with Mucocutaneous, Articular, and Systemic Manifestations

Castori¹

2012

ISRN Dermatology

176

239

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Ehlers-Danlos syndrome, hypermobility type, constituting a phenotypic continuum with or, perhaps, corresponding to the joint hypermobility syndrome (JHS/EDS-HT), is likely the most common, though the least recognized, heritable connective tissue disorder. Known for decades as a hereditary condition with predominant rheumatologic manifestations, it is now emerging as a multisystemic disorder with widespread manifestations. Nevertheless, the practitioners' awareness of this condition is generally poor and most patients await years or, perhaps, decades before reaching the correct diagnosis. Among the various sites of disease manifestations, skin and mucosae represent a neglected organ where the dermatologist can easily spot diagnostic clues, which consistently integrate joint hypermobility and other orthopedic/neurologic manifestations at physical examination. In this paper, actual knowledge on JHS/EDS-HT is summarized in various sections. Particular attention has been posed on overlooked manifestations, including cutaneous, mucosal, and oropharyngeal features, and early diagnosis techniques, as a major point of interest for the practicing dermatologist. Actual research progresses on JH/EDS-HT envisage an unexpected link between heritable dysfunctions of the connective tissue and a wide range of functional somatic syndromes, most of them commonly diagnosed in the office of various specialists, comprising dermatologists.

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Association between Psychopathological Factors and Joint Hypermobility Syndrome in a Group of Undergraduates from a French University

Abstract: JHS is a frequent condition among young people evaluated. JHS is associated with psychological distress and higher levels of somatosensory amplification.

Cited by 40 publications

References 22 publications

Joint hypermobility syndrome: problems that require psychological intervention

Joint hypermobility syndrome: problems that require psychological intervention

Postural Tachycardia Syndrome: A Heterogeneous and Multifactorial Disorder

Ehlers-Danlos Syndrome, Hypermobility Type: An Underdiagnosed Hereditary Connective Tissue Disorder with Mucocutaneous, Articular, and Systemic Manifestations

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