Joint hypermobility syndrome: problems that require psychological intervention

Abstract

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.

Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder

“…Although an inflammatory component is rare, EDS-HT carries a high potential for disability13 due to recurrent dislocations and subluxations and chronic pain 8,11,12,14,15. Throughout the years, extra-articular manifestations have been described, including cardiovascular and autonomic nervous system,16–22 gastrointestinal,19,23 hematologic,24–26 ocular,27 gynecologic,19,28–31 neurologic,19,25,32,33 and psychiatric manifestations,7,8,11,19,34,35 emphasizing the multisystemic nature of EDS-HT. Unfortunately, EDS-HT is under-recognized and inadequately managed,36–38 leading to neglect of these patients which may lead to severe disability that almost certainly could have been avoided 39…”

Systemic Manifestations of Ehlers-Danlos Syndrome Hypermobility Type

“…Pain and fatigue are the most common complaints in the daily clinical practice, followed by nocturnal insomnia and morning drowsiness, dysautonomia, dyslexia and neuropsychological disorders. Furthermore subjects suffer from conditions related to the restorative phases of sleep such as musculoskeletal pain, impaired concentration and cognitive deficits, which are explained, at least in part, by higher organic energy consumption [10,17,18,20,22]. In this context, there is impairment to activities of daily living, and to the professional and sports life of individuals, a situation that requires an understanding of the order of appearance and prevalence of signs and symptoms in the general population with an emphasis on this diversity of manifestations, a condition that currently suggests analyzes of signs and symptoms based on disturbances of the hyper mobile spectrum.…”

“…Chronic fatigue is present in most patients, manifesting with a persistent sensation of fatigue, lack of energy and feeling of exhaustion, with impairment to concentration [16]. Pain is the main complaint, with chronicity and consequences on quality of life, including sleep loss, and impaired social and work relationships, sexual function, and physical and recreational activities resulting in depression with psychosocial consequences [22] (Figure 1-14). …”

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“…Furthermore subjects suffer from conditions related to the restorative phases of sleep such as musculoskeletal pain, impaired concentration and cognitive deficits, which are explained, at least in part, by higher organic energy consumption. 10,17,18,20,22 In this context, there is impairment to activities of daily living, and to the professional and sports life of individuals, a situation that requires an understanding of the order of appearance and prevalence of signs and symptoms in the general population with an emphasis on this diversity of manifestations, a condition that currently suggests analyzes of signs and symptoms based on disturbances of the hyper mobile spectrum.…”