Joint hypermobility syndrome is a risk factor trait for anxiety disorders: a 15-year follow-up cohort study
Abstract
Objective The objective of the study was to assess whether joint hypermobility syndrome (JHS) is a risk factor for developing anxiety disorders using a 15-year prospective cohort study.Method The initial cohort recruited 158 subjects aged 16 to 20 years from the general population in a Spanish rural town. The cohort was studied at baseline and at a 15-year follow-up. Joint hypermobility syndrome was assessed using Beighton's criteria, and the psychiatric disorders were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders. Subjects with anxiety disorders at baseline were excluded from the follow-up.Results Joint hypermobility syndrome at baseline was found in 29 of 158 subjects (21.1%). Cumulative incidence of panic/agoraphobia disorder at follow-up, as main diagnosis, was significantly higher for the JHS group (41.4%) than for the control group (1.9%), with a relative risk of 22.3 [95% confidence interval (CI) 4.6-108.7, P<.0001] (Number Needed to Treat [NNT] 3, 95% CI 2.9-2.3). Incidence of social phobia and simple phobia was also significantly higher for the JHS group [relative risk (RR)=6.52, 95% CI 1.7-24.2, P<.001 and RR=3.31, 95% CI 1.1-9.6, P=.02, respectively]. Moreover, anxiolytic drug use was nearly fourfold higher among JHS compared to non-JHS subjects.Conclusion Joint hypermobility syndrome was associated with higher risk of developing anxiety disorders. If replicated, these findings may give enhanced value to JHS assessment in clinical and general population studies.
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EDS and HSD are associated with increased risk of depression, anxiety, and interpersonal issues compared to the general population.
“EDS and HSD have been associated with increased risk of conditions such as depression and anxiety as well as interpersonal issues when compared to the general population [17–21].”
From Psychological interventions for individuals with Ehlers-Danlos syndrome and hypermobility spectrum disorder: a scoping review (2023) · cites this paper as [18]
Such an association between GJH and anxiety is widely reported in adults.
“This observation is striking as such an association is widely reported in adults.10 13 42”
From Variant connective tissue (joint hypermobility) and its relevance to depression and anxiety in adolescents: a cohort-based case–control study (2022) · cites this paper as [42]
Adults with asymptomatic GJH have more specific anxiety (state, trait, social anxiety, and severity of fears) than controls without asymptomatic GJH.
“Adults with asymptomatic GJH had higher anxiety scores42,43 and more specific anxiety as state, trait anxiety, social anxiety, and severity of fears than controls without asymptomatic GJH.33, 34, 35, 36”
From Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review (2025) · cites this paper as [35]
Contradictory results exist on the frequency of fears in healthy adults with asymptomatic GJH compared to peers without asymptomatic GJH.
“Contradictory results were found on the frequency of fears in healthy adults with asymptomatic GJH compared to peers without asymptomatic GJH.34,35”
From Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review (2025) · cites this paper as [35]
Joint hypermobility represents a risk factor for developing anxiety disorders.
“and represents a risk factor trait for developing anxiety disorders (Bulbena et al., 2011).”
From Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility (2014) · cites this paper as Bulbena et al., 2011
The association between joint hypermobility and the clinical expression of anxiety is now robustly established.
“The association between joint hypermobility and the clinical expression of anxiety is now robustly established (Bulbena et al., 2011; Bianchi Sanches et al., 2012).”
From Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility (2014) · cites this paper as Bulbena et al., 2011
In a long-term population cohort study with 15 years of follow-up, those with HSD/hEDS defined by Brighton criteria at recruitment (29 of 137 subjects) had a relative risk of panic disorder or agoraphobia 22 times greater than that of non-HSD/hEDS patients.
“In a long term population cohort study with 15 years of follow up, those patients with HSD/hEDS defined by Brighton criteria performed at the time of recruitment (29 of the 137 subjects) had a relative risk of panic disorder or agoraphobia 22 times greater than that of the non‐HSD/hEDS patients. 18”
From Hypermobile Ehlers–Danlos syndrome and disorders of the gastrointestinal tract: What the gastroenterologist needs to know (2022) · cites this paper as [18]
Higher rates of anxiety and depression in BJHS may be due to pain-related fear and fear avoidance, but studies are scarce to clarify this relationship.
“Previously described in BJHS, higher rates of anxiety and depression may be due to pain-related fear and fear avoidance, but studies are scarce to clarify this relationship.[8,35,36]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [36]
Cites
(1988) · NFER-Nelson eBooks · Cited by 5,560 · see citing works
Hulley, S. B. (1997) · Cited by 1,753 · see citing works
Articular mobility in an African population.
Beighton, P., Solomon, L., & Soskolne, C. L. (1973) · Annals of the Rheumatic Diseases · doi:10.1136/ard.32.5.413 · Cited by 1,727 · see citing works
Prevalence and incidence studies of anxiety disorders: A systematic review of the literature
Somers, J. M., Goldner, E. M., Waraich, P., & Hsu, L. (2006) · The Canadian Journal of Psychiatry · doi:10.1177/070674370605100206 · Cited by 1,114 · see citing works
Psychometric properties of the Liebowitz Social Anxiety Scale
HEIMBERG, R. G., HORNER, K. J., JUSTER, H. R., SAFREN, S. A., BROWN, E. J., SCHNEIER, F. R., & LIEBOWITZ, M. R. (1999) · Psychological Medicine · doi:10.1017/s0033291798007879 · Cited by 968 · see citing works
(2000) · PubMed · Cited by 738 · see citing works
Anxiety sensitivity and panic disorder
McNally, R. J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01475-0 · Cited by 717 · see citing works
Kirby, R. S. (2014) · Annals of Epidemiology · doi:10.1016/j.annepidem.2014.01.010 · Cited by 681 · see citing works
(1988) · American Journal of Psychiatry · doi:10.1176/ajp.145.8.976 · Cited by 641 · see citing works
Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population
Lobo, A., Perez-Echeverria, M. J., & Artal, J. (1986) · Psychological Medicine · doi:10.1017/s0033291700002579 · Cited by 535 · see citing works
Dysautonomia in the joint hypermobility syndrome
Gazit, Y., Nahir, A. M., Grahame, R., & Jacob, G. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00235-3 · Cited by 390 · see citing works
The ESEMeD/MHEDEA 2000 investigators, Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., de Girolamo, G., de Graaf, R., Demyttenaere, K., et al. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0047.2004.00331.x · Cited by 313 · see citing works
Hakim, A., & Grahame, R. (2003) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2003.08.001 · Cited by 289 · see citing works
Gratacòs, M., Nadal, M., Martín‐Santos, R., Pujana, M. Á., Gago, J., Peral, B., Armengol, L., Ponsa, I., Miró, R., Bulbena, A., et al. (2001) · Cell · doi:10.1016/s0092-8674(01)00447-0 · Cited by 215 · see citing works
Self-citationClinical assessment of hypermobility of joints: assembling criteria.
Bulbena, A., Duró, J. C., Porta, M. S., Faus, S., Vallescar, R., & Martín‐Santos, R. (1992) · PubMed · Cited by 199 · see citing works
Self-citationLewkonia, R. M. (1987) · Archives of Disease in Childhood · doi:10.1136/adc.62.1.1 · Cited by 180 · see citing works
MOORE, M. (1976) · The Lancet · doi:10.1016/s0140-6736(76)92514-9 · Cited by 167 · see citing works
Association Between Joint Hypermobility Syndrome and Panic Disorder
Martín‐Santos, R., Bulbena, A., Porta, M. S., Gago, J., Balaguer, L. M., & Duró, J. C. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.11.1578 · Cited by 137 · see citing works
Self-citationCuestionario de ansiedad estado-rasgo: manual
Spielberger, C. D., Cubero, N. S., Gorsuch, R. L., & Lushene, R. E. (1982) · Dialnet (Universidad de la Rioja) · Cited by 136 · see citing works
Bobes, J., Badia, X. C., Luque, A., García, M., González, M. P., & Dal−Ré, R. (1999) · PubMed · Cited by 135 · see citing works
Anxiety disorders in the joint hypermobility syndrome
Bulbena, A., Duró, J. C., Porta, M., Martín-Santos, R., Mateo, A., Molina, L., Vallescar, R., & Vallejo, J. (1993) · Psychiatry Research · doi:10.1016/0165-1781(93)90008-5 · Cited by 118 · see citing works
Self-citationAnxiety Sensitivity Index: normative data and its differentiation from trait anxiety
Sandín, B., Chorot, P., & McNally, R. J. (2001) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(00)00009-7 · Cited by 86 · see citing works
JOINT HYPERMOBILITY SYNDROME AND ANXIETY DISORDERS
Bulbena, A., Duró, J. C., Mateo, A., Porta, M. S., & Vallejo, J. (1988) · The Lancet · doi:10.1016/s0140-6736(88)90514-4 · Cited by 77 · see citing works
Self-citationIs Joint Hypermobility Related to Anxiety in a Nonclinical Population Also?
Bulbena, A., Agulló, A., Pailhez, G., Martín-Santos, R., Porta, M., Guitart, J., & Gago, J. (2004) · Psychosomatics · doi:10.1176/appi.psy.45.5.432 · Cited by 76 · see citing works
Self-citationHärter, M. C., Reuter, K., Weisser, B., Schretzmann, B., Aschenbrenner, A., & Bengel, J. (2002) · Archives of Physical Medicine and Rehabilitation · doi:10.1053/apmr.2002.30924 · Cited by 64 · see citing works
Age effects on the clinical presentation of alcoholics at a psychiatric hospital
Cornelius, J. R., Fábrega, H., Maher, P. J., Jones-Barlock, A., Salloum, I. M., Ulrich, R. F., & Mezzich, J. E. (1997) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(97)90029-8 · Cited by 57 · see citing works
The relationship between frequency and intensity of fears and a collagen condition
Bulbena, A., Gago, J., Sperry, L., & Bergé, D. (2006) · Depression and Anxiety · doi:10.1002/da.20160 · Cited by 35 · see citing works
Self-citationAnxiety disorders: a conceptual history
Berrios, G. E. (1999) · Journal of Affective Disorders · doi:10.1016/s0165-0327(99)00036-1 · Cited by 35 · see citing works
What can be learnt from the natural history of anxiety disorders?
Rubio, G., & López-Ibor, J. J. (2006) · European Psychiatry · doi:10.1016/j.eurpsy.2006.09.007 · Cited by 29 · see citing works
The long-term treatment outcomes of depression and anxiety comorbid with substance abuse
BOVASSO, G. B. (2001) · The Journal of Behavioral Health Services & Research · doi:10.1007/bf02287233 · Cited by 21 · see citing works
“Connective tissue” between panic disorder and dysautonomia
Bulbena, A., Pailhez, G., & Gago, J. (2004) · The American Journal of Medicine · doi:10.1016/j.amjmed.2003.11.032 · Cited by 18 · see citing works
Self-citationRacial effects on the clinical presentation of alcoholics at a psychiatric hospital
Cornelius, J. R., Fábrega, H., Cornelius, M. D., Mezzich, J. E., Maher, P. J., Salloum, I. M., Thase, M. E., & Ulrich, R. F. (1996) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(96)90569-6 · Cited by 16 · see citing works
Joint Hypermobility in Schizophrenia: A Potential Marker for Co-Morbid Anxiety
Bulbena, A., Sperry, L. D., Anguiano, B., Pailhez, G., & Gago, J. (2007) · The Open Psychiatry Journal · doi:10.2174/1874354400701010031 · Cited by 14 · see citing works
Self-citationNo evidence for DNA copy number change associated with the DUP25 cytogenetic phenotype
Hollox, E. J., & Armour, J. A. L. (2003) · European Journal of Human Genetics · doi:10.1038/sj.ejhg.5201074 · Cited by 6 · see citing works
The relativity of relative risks: disadvantage or opportunity?
Neeleman, J. (2003) · The British Journal of Psychiatry · doi:10.1192/bjp.182.2.101 · Cited by 6 · see citing works
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1 of the 36 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Moreno-Peral, P., Cerón, S. C., Motrico, E., Morejón, A. R., Fernández, A., García‐Campayo, J., Roca, M., Serrano‐Blanco, A., Rubio-Valera, M., & Bellón, J. Á. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.06.021 · Cited by 198 · see citing works
Joint Hypermobility Syndrome: Recognizing a Commonly Overlooked Cause of Chronic Pain
Kumar, B., & Lenert, P. (2017) · The American Journal of Medicine · doi:10.1016/j.amjmed.2017.02.013 · Cited by 153 · see citing works
Psychiatric and psychological aspects in the Ehlers–Danlos syndromes
Bulbena, A., Baeza‐Velasco, C., Bulbena‐Cabré, A., Pailhez, G., Critchley, H., Chopra, P., Mallorquí‐Bagué, N., Frank, C., & Porges, S. (2017) · American Journal of Medical Genetics Part C: Seminars in Medical Genetics · doi:10.1002/ajmg.c.31544 · Cited by 149 · see citing works
Self-citationCederlöf, M., Larsson, H., Lichtenstein, P., Almqvist, C., Serlachius, E., & Ludvigsson, J. F. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0922-6 · Cited by 142 · see citing works
“The same authors recently reported that hypermobility was linked to a 22-fold increased risk of panic/ agoraphobia disorders and a 4-fold increase in the use of anxiolytic drugs in patients with hypermobility [10].”
BackgroundSmith, T. O., Easton, V., Bacon, H., Jerman, E., Armon, K., Poland, F., & Macgregor, A. J. (2014) · Rheumatology · doi:10.1093/rheumatology/ket317 · Cited by 130 · see citing works
Mulvey, M. R., Macfarlane, G. J., Beasley, M., Symmons, D. P. M., Lovell, K., Keeley, P., Woby, S., & McBeth, J. (2013) · Arthritis Care & Research · doi:10.1002/acr.21979 · Cited by 115 · see citing works
Fikree, A., Aktar, R., Grahame, R., Hakim, A. J., Morris, J. K., Knowles, C. H., & Aziz, Q. (2015) · Neurogastroenterology & Motility · doi:10.1111/nmo.12535 · Cited by 117 · see citing works
Fikree, A., Grahame, R., Aktar, R., Farmer, A. D., Hakim, A. J., Morris, J. K., Knowles, C. H., & Aziz, Q. (2014) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2014.01.014 · Cited by 104 · see citing works
Scheper, M., de Vries, J. E., Verbunt, J., & Engelbert, R. H. H. (2015) · Journal of Pain Research · doi:10.2147/jpr.s64251 · Cited by 105 · see citing works
MallorquÃ-Bagué, N., Garfinkel, S. N., Engels, M., Eccles, J. A., Pailhez, G., Bulbena, A., & Critchley, H. D. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.01162 · Cited by 97 · see citing works
Self-citationMind-Body Interactions in Anxiety and Somatic Symptoms
Mallorquí-Bagué, N., Bulbena, A., Pailhez, G., Garfinkel, S. N., & Critchley, H. D. (2016) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000085 · Cited by 96 · see citing works
Self-citationBeckers, A. B., Keszthelyi, D., Fikree, A., Vork, L., Masclee, A., Farmer, A. D., & Aziz, Q. (2017) · Neurogastroenterology & Motility · doi:10.1111/nmo.13013 · Cited by 90 · see citing works
Berglund, B., Pettersson, C., Pigg, M., & Kristiansson, P. (2015) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-015-0549-7 · Cited by 89 · see citing works
Sinibaldi, L., Ursini, G., & Castori, M. (2015) · American Journal of Medical Genetics Part C: Seminars in Medical Genetics · doi:10.1002/ajmg.c.31430 · Cited by 87 · see citing works
Hershenfeld, S. A., Wasim, S., McNiven, V., Parikh, M., Majewski, P., Faghfoury, H., & So, J. (2016) · Rheumatology International · doi:10.1007/s00296-015-3375-1 · Cited by 81 · see citing works
Quality of life prediction in children with joint hypermobility syndrome
Pacey, V., Tofts, L., Adams, R. D., Munns, C. F., & Nicholson, L. L. (2015) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.12826 · Cited by 77 · see citing works
Postural tachycardia syndrome: current perspectives
Wells, R. M., Spurrier, A. J., Linz, D., Gallagher, C., Mahajan, R., Sanders, P., Page, A. J., & Lau, D. H. (2017) · Vascular Health and Risk Management · doi:10.2147/vhrm.s127393 · Cited by 69 · see citing works
Baeza-Velasco, C., Pailhez, G., Bulbena, A., & Baghdadli, A. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2014.10.002 · Cited by 67 · see citing works
Self-citationJoint Hypermobility: A Common Association with Complex Functional Gastrointestinal Disorders
Kovacic, K., Chelimsky, T. C., Sood, M. R., Simpson, P., Nugent, M., & Chelimsky, G. (2014) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2014.07.021 · Cited by 67 · see citing works
Bulbena, A., Pailhez, G., Bulbena-Cabré, A., Mallorquí-Bagué, N., & Baeza-Velasco, C. (2015) · Advances in Psychosomatic Medicine · doi:10.1159/000369113 · Cited by 60 · see citing works
Self-citationThwaites, P. A., Gibson, P. R., & Burgell, R. E. (2022) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.15927 · Cited by 59 · see citing works
Simmonds, J. V., Herbland, A., Hakim, A., Ninis, N., Lever, W., Aziz, Q., & Cairns, M. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1398278 · Cited by 60 · see citing works
Krahe, A. M., Adams, R. D., & Nicholson, L. L. (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1323022 · Cited by 54 · see citing works
Pasquini, M., Celletti, C., Berardelli, I., Roselli, V., Mastroeni, S., Castori, M., Biondi, M., & Camerota, F. (2014) · Rheumatology International · doi:10.1007/s00296-013-2901-2 · Cited by 51 · see citing works
Juul‐Kristensen, B., Østengaard, L., Hansen, S. M.-B., Boyle, E., Junge, T., & Hestbæk, L. (2017) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-017-1595-0 · Cited by 46 · see citing works
Hypermobility spectrum disorders: A review
Carroll, M. B. (2023) · Rheumatology and Immunology Research · doi:10.2478/rir-2023-0010 · Cited by 45 · see citing works
Wasim, S., Suddaby, J. S., Parikh, M., Leylachian, S., Ho, B., Guerin, A., & So, J. (2019) · Rheumatology International · doi:10.1007/s00296-019-04293-w · Cited by 44 · see citing works
Pacey, V., Tofts, L., Adams, R. D., Munns, C. F., & Nicholson, L. L. (2013) · Pediatric Rheumatology · doi:10.1186/1546-0096-11-30 · Cited by 43 · see citing works
Pain Phenotypes in Rare Musculoskeletal and Neuromuscular Diseases
Tucker-Bartley, A., Lemme, J. D., Gomez-Morad, A. D., Shah, N. A., Veliu, M., Birklein, F., Storz, C., Rutkove, S. B., Kronn, D., Boyce, A. M., et al. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.02.009 · Cited by 42 · see citing works
Konopinski, M., Graham, I., Johnson, M. I., & Jones, G. (2015) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2015.12.006 · Cited by 37 · see citing works
Neurovisceral phenotypes in the expression of psychiatric symptoms
Eccles, J., Owens, A. P., Mathias, C. J., Umeda, S., & Critchley, H. (2015) · Frontiers in Neuroscience · doi:10.3389/fnins.2015.00004 · Cited by 36 · see citing works
Fikree, A., Aktar, R., Morris, J. K., Grahame, R., Knowles, C. H., & Aziz, Q. (2017) · Neurogastroenterology & Motility · doi:10.1111/nmo.12942 · Cited by 33 · see citing works
Anxiety and joint hypermobility association: a systematic review
Sanches, S. B., Osório, F. D. L., Udina, M., Martín‐Santos, R., & Crippa, J. A. S. (2012) · Brazilian Journal of Psychiatry · doi:10.1016/s1516-4446(12)70054-5 · Cited by 33 · see citing works
Joint Hypermobility and Headache: Understanding the Glue That Binds the Two Together – Part 1
Neilson, D., & Martin, V. T. (2014) · Headache The Journal of Head and Face Pain · doi:10.1111/head.12418 · Cited by 31 · see citing works
den Hollander, M., Smeets, R. J. E. M., van Meulenbroek, T., van Laake-Geelen, C. C. M., Baadjou, V. A., & Timmers, I. (2022) · Physical Therapy · doi:10.1093/ptj/pzab270 · Cited by 30 · see citing works
van Meulenbroek, T., Huijnen, I. P. J., Simons, L. E., Conijn, A. E. A., Engelbert, R. H. H., & Verbunt, J. A. (2021) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2020-0023 · Cited by 30 · see citing works
“Furthermore, an increased incidenceof other psychiatric disorders, including panic disorders [58, 69] and anxiety disorders [67, 68, 70] were found to be associatedwithG-HSD/hEDS.”
BackgroundAnxiety and joint hypermobility association: a systematic review
Bianchi Sanches, S. H., Osório, F. D. L., Udina, M., Martín-Santos, R., & Crippa, J. A. S. (2012) · Revista Brasileira de Psiquiatria · doi:10.1590/s1516-44462012000500005 · Cited by 29 · see citing works
Russek, L. N., LaShomb, E. A., Ware, A. M., Wesner, S. M., & Westcott, V. (2014) · Physiotherapy Research International · doi:10.1002/pri.1613 · Cited by 29 · see citing works
Bulbena, A., Mallorquí‐Bagué, N., Pailhez, G., Rosado, S., González, I., Blanch‐Rubió, J., & Abelló, J. C. (2014) · The European Journal of Psychiatry · doi:10.4321/s0213-61632014000100002 · Cited by 23 · see citing works
Self-citationMallorquí‐Bagué, N., Bulbena, A., Roé-Vellvé, N., Hoekzema, E. A., Carmona, S., Barba‐Müller, E., Fauquet, J., Pailhez, G., & Vilarroya, Ó. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2015.01.004 · Cited by 23 · see citing works
Self-citationEccles, J. A., Quadt, L., McCarthy, H., Davies, K. A., Bond, R., David, A. S., Harrison, N. A., & Critchley, H. D. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-066130 · Cited by 20 · see citing works
Functional Gastrointestinal Disorders and Joint Hypermobility: A School‐based Study
Saps, M., Blom, P. J. J., Velasco‐Benitez, C. A., & Benninga, M. A. (2018) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001724 · Cited by 19 · see citing works
Csecs, J. L. L., Dowell, N. G., Savage, G. K., Iodice, V., Mathias, C. J., Critchley, H., & Eccles, J. (2021) · American Journal of Medical Genetics Part C Seminars in Medical Genetics · doi:10.1002/ajmg.c.31957 · Cited by 18 · see citing works
Bowen, J., Fatjó, J., Serpell, J. A., Bulbena-Cabré, A., Leighton, E., & Bulbena, A. (2019) · Scientific Reports · doi:10.1038/s41598-019-45096-0 · Cited by 17 · see citing works
Folci, M., & CAPSONI, F. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-0905-2 · Cited by 17 · see citing works
Functional somatic syndromes and joint hypermobility: A systematic review and meta-analysis
Chen, G. H., Olver, J. S., & Kanaan, R. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110556 · Cited by 15 · see citing works
Ehlers-Danlos Syndromes, Joint Hypermobility and Hypermobility Spectrum Disorders
Micale, L., Fusco, C., & Castori, M. (2021) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-80614-9_9 · Cited by 16 · see citing works
Rocchetti, M., Bassotti, A., Corradi, J., Damiani, S., Pasta, G., Annunziata, S., Guerrieri, V., Mosconi, M., Gentilini, D., & Brondino, N. (2021) · Healthcare · doi:10.3390/healthcare9111472 · Cited by 14 · see citing works
Joint hypermobility syndrome: A risk factor for fixed dystonia?
Kassavetis, P., Batla, A., Pareés, I., Saifee, T. A., Schrag, A. E., Cordivari, C., Bhatia, K. P., & Edwards, M. J. (2012) · Movement Disorders · doi:10.1002/mds.25004 · Cited by 14 · see citing works
Both anxiety and joint laxity determine the olfactory features in panic disorder
Burón, E., Bulbena, A., Bulbena-Cabré, A., Rosado, S., & Pailhez, G. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.018 · Cited by 14 · see citing works
Self-citationCelletti, C., & Camerota, F. (2013) · PubMed · doi:10.7417/ct.2013.1597 · Cited by 13 · see citing works
Biobehavioral approach to distinguishing panic symptoms from medical illness
Tunnell, N. C., Corner, S. E., Roque, A. D., Kroll, J. L., Ritz, T., & Meuret, A. E. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1296569 · Cited by 15 · see citing works
Orenius, T., Kautiainen, H., Louhi, M., Montin, L., Bulbena, A., & Lindgren, K. (2022) · SAGE Open · doi:10.1177/21582440221091237 · Cited by 12 · see citing works
Self-citationSanches, S. B., Osório, F. L., Louzada-Junior, P., Moraes, D., Crippa, J. A. S., & Martín-Santos, R. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.08.016 · Cited by 12 · see citing works
Ehlers–Danlos Syndrome: Not Just Joint Hypermobility
Bregant, T., & Klopcić-Spevak, M. (2018) · Case Reports in Medicine · doi:10.1155/2018/5053825 · Cited by 11 · see citing works
Joint hypermobility is a marker for anxiety in children
Bulbena-Cabré, A., Duñó, L., Almeda, S., Batlle, S., Camprodon-Rosanas, E., Martín-López, L. M., & Bulbena, A. (2019) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2019.05.001 · Cited by 3 · see citing works
Self-citationAkkaya, K. U., Burak, M., Erturan, S., Yıldız, R., Yıldız, A., & Elbasan, B. (2022) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2022.102642 · Cited by 13 · see citing works
La hiperlaxitud articular como marcador de ansiedad en niños
Bulbena-Cabre, A., Duñó, L., Almeda, S., Batlle, S., Camprodon-Rosanas, E., Martín-Lopez, L. M., & Bulbena, A. (2019) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2019.01.004 · Cited by 12 · see citing works
Self-citationHerbst, K. L., Zelaya, C., Sommerville, M., Zimmerman, T., & McHutchison, L. (2025) · Life · doi:10.3390/life15050725 · Cited by 10 · see citing works
Davies, G., Csecs, J. L. L., Ball, H., Dare, J., Bremner, S. A., Hosking, R., Critchley, H., Grey, N., & Eccles, J. (2021) · Trials · doi:10.1186/s13063-021-05555-4 · Cited by 10 · see citing works
Joint Hypermobility and Clinical Correlates in a Group of Patients With Eating Disorders
Baeza‐Velasco, C., Sénèque, M., Courtet, P., Olié, É., Chatenet, C., Espinoza, P., Dorard, G., & Guillaume, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.803614 · Cited by 10 · see citing works
Prevalence of generalized joint hypermobility in children with anxiety disorders
Javadi Parvaneh, V., Modaress, S., Zahed, G., Rahmani, K., & Shiari, R. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03377-0 · Cited by 9 · see citing works
Smith, S. J., Smith, B. H., Sichlau, M. J., Chen, B., Knight, D. R. T., & Rowe, P. C. (2024) · Phlebology The Journal of Venous Disease · doi:10.1177/02683555241273109 · Cited by 10 · see citing works
Gozalo-Pascual, R., Ordí, H. G., Atín-Arratibel, M. D. L. Á., Llames-Sánchez, J., & Álvarez-Melcón, Á. C. (2023) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2023.101753 · Cited by 9 · see citing works
Coplan, J. D., Singh, D., Gopinath, S., Mathew, S. J., & Bulbena, A. (2015) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.14060132 · Cited by 9 · see citing works
Self-citationSchlager, A., Ahlqvist, K., Pingel, R., Nilsson-Wikmar, L. B., Olsson, C., & Kristiansson, P. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03524-7 · Cited by 9 · see citing works
Effects of Rhythmic Sensory Stimulation on Ehlers–Danlos Syndrome: A Pilot Study
Vuong, V., Mosabbir, A., Paneduro, D., Picard, L. M., Faghfoury, H., Evans, M., GORDON, A. S., & Bartel, L. (2020) · Pain Research and Management · doi:10.1155/2020/3586767 · Cited by 9 · see citing works
Loganathan, P., Herlihy, D., Gajendran, M., Gonzalez, Z., Chavez, L. O., Espino, K., & McCallum, R. W. (2024) · Journal of Investigative Medicine · doi:10.1177/10815589231210486 · Cited by 8 · see citing works
Song, J. Z., Luong, D., Feldman, E. C. H., Tran, S., Perrier, L., Eubanks, K., Bayley, M., Kastner, M., Slepian, M., & Munce, S. E. P. (2023) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-023-02799-y · Cited by 9 · see citing works
Pain in Ehlers–Danlos Syndrome: A Non-Diagnostic Disabling Symptom?
Guerrieri, V., Polizzi, A., Caliogna, L., Brancato, A. M., Bassotti, A., Torriani, C., Jannelli, E., Mosconi, M., Grassi, F. A., & Pasta, G. (2023) · Healthcare · doi:10.3390/healthcare11070936 · Cited by 8 · see citing works
Joint hypermobility is also associated with anxiety disorders in the elderly population
Bulbena‐Cabré, A., Rojo, C., Pailhez, G., Buron Maso, E., Martín‐Lopez, L. M., & Bulbena, A. (2018) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4733 · Cited by 10 · see citing works
Self-citationSchubert-Hjalmarsson, E., Fasth, A. L., Ickmans, K., Söderpalm, A., & Lundberg, M. (2024) · European Journal of Pain · doi:10.1002/ejp.4754 · Cited by 8 · see citing works
Clinical management of benign joint hypermobility syndrome: a case series.
Boudreau, P. A., Steiman, I., & Mior, S. A. (2020) · PubMed Central · Cited by 7 · see citing works
Is femoral trochlear dysplasia related to global joint hypermobility?
Erden, T., Aksoy, D. Ö., Ceylan, H. H., Kapıcıoğlu, M., Bilsel, K., & Elmalı, N. (2018) · Journal of Orthopaedic Science · doi:10.1016/j.jos.2018.10.008 · Cited by 7 · see citing works
van Meulenbroek, T., Huijnen, I. P. J., Wiertz, C. M. H., & Verbunt, J. A. (2017) · Journal of Orthopaedic & Sports Physical Therapy · doi:10.2519/jospt.2017.7282 · Cited by 8 · see citing works
Pailhez, G., Rosado, S., Baeza‐Velasco, C., & Bulbena, A. (2014) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2014.894074 · Cited by 6 · see citing works
Self-citationLyell, M. J., Simmonds, J. V., & Deane, J. A. (2016) · Physiotherapy Practice and Research · doi:10.3233/ppr-160073 · Cited by 6 · see citing works
Neurobiological and neuropsychological disturbance in EDS
Westerman, M., Kafkas, A., Parry‐Jones, A., Strong, S., Retzler, C., & Hallam, G. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1648702 · Cited by 5 · see citing works
Alsiri, N., & Palmer, S. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1062808 · Cited by 5 · see citing works
Recognizing the Scale of Joint Hypermobility Burden: Comment on the Article by Mulvey et al
Hakim, A. J., & Grahame, R. (2013) · Arthritis Care & Research · doi:10.1002/acr.22221 · Cited by 5 · see citing works
Parvaneh, V. J., Shahvaladi, H., Rahmani, K., Yekta, S. J., Gorji, F. A., Shiari, R., & Abdollahimajd, F. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03264-8 · Cited by 4 · see citing works
First-episode olfactory hallucination in a patient with anxiety disorder: A case report
Jiang, X., Yuan, Y., Li, Z., Ou, Y., & Li, Z. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.990341 · Cited by 4 · see citing works
Hypermobility and autonomic hyperactivity : relevance for the expression of psychiatric symptoms
Eccles, J. (2016) · Cited by 4 · see citing works
Llach, C.-D., Pailhez, G., Conejo-González, C., Singh, P. M., & Bulbena, A. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02559-8 · Cited by 3 · see citing works
Self-citationSanches, C. J. (2014) · Journal of Depression & Anxiety · doi:10.4172/2167-1044.1000144 · Cited by 3 · see citing works
Bulbena, A., Rosado, S., Cabaleiro, M., Martínez, M. P., Baeza‐Velasco, C., Martin, L.-M., Batlle, S., & Bulbena‐Cabré, A. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1039223 · Cited by 3 · see citing works
Self-citationSomatic Conditions Intrinsic to Anxiety Disorders
Bulbena, A., & Pailhez, G. (2011) · InTech eBooks · doi:10.5772/19097 · Cited by 3 · see citing works
Self-citationJoint Hypermobility, Anxiety, and Psychosomatics — The New Neuroconnective Phenotype
Pailhez, G., Castaño, J., Rosado, S., Ballester, M. D. M., Vendrell, C., Mallorquí‐Bagué, N., Baeza‐Velasco, C., & Bulbena, A. (2015) · InTech eBooks · doi:10.5772/60607 · Cited by 3 · see citing works
Self-citationSyndrome d’Ehlers-Danlos hypermobile : considérations psychologiques
Baeza‐Velasco, C., Bulbena, A., Pailhez, G., Bourdon, C., & de Jouvencel, M. (2015) · Journal de Réadaptation Médicale Pratique et Formation en Médecine Physique et de Réadaptation · doi:10.1016/j.jrm.2015.09.004 · Cited by 3 · see citing works
Self-citationBevilacqua, D. E. (2019) · Archives of Rheumatology & Arthritis Research · doi:10.33552/arar.2019.01.000502 · Cited by 3 · see citing works
Co-Morbid Anxiety and Physical Disorders: A Possible Common Link with Joint Hypermobility Syndrome
Pailhez, G., & Bulbe, A. (2013) · InTech eBooks · doi:10.5772/51892 · Cited by 2 · see citing works
Self-citationConnective tissue problems and attention deficit and hyperactivity
Baeza‐Velasco, C., Soussana, M., & Baghdadli, A. (2014) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-014-0161-y · Cited by 2 · see citing works
Graded exposure in de praktijk: de behandeling bij jongeren
Spek, E. M., van Menxel, D. A. J., Ummels, B. J. A. G., van Meulenbroek, T., & Verbunt, J. (2016) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-1106-4_11 · Cited by 2 · see citing works
The Etiology of Temporomandibular Disorders
Khatib, F. A., & Utreja, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-57563-1_2 · Cited by 2 · see citing works
Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review
van Die-de Vries, J. E., Rameckers, E., Calders, P., Engelbert, R. H., Ramaekers, S. P., Goossens, M. E., & Verbunt, J. A. (2025) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2025.100467 · Cited by 1 · see citing works
“…Contradictory results were found on the frequency of fears in healthy adults with asymptomatic GJH compared to peers without asymptomatic GJH. 34,35 Psychological distress including anxiety was signi fi cantly higher within adults with asymptomatic GJH compared to healthy controls but did not…”
Singh, D., Martinez, W. R., Anand, N., Pinkhasov, A., Calixte, R., Bulbena, A., & Coplan, J. D. (2019) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.18080174 · Cited by 1 · see citing works
Self-citationFunctional Gastrointestinal Disorders and the Joint Hypermobility Syndrome
Fikree, A. (2013) · Cited by 1 · see citing works
Social aerial circus : female experience, self-perception and self-representation
Watt, C. (2019) · University of Brighton Repository (University of Brighton) · Cited by 1 · see citing works
Eccles, J. A., Scott, H. E., Davies, K. A., Bond, R., David, A. S., Harrison, N. A., & Critchley, H. D. (2020) · doi:10.1101/2020.09.14.20191130 · Cited by 1 · see citing works
Alsiri, N., & Palmer, S. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4157897 · Cited by 1 · see citing works
- Authors
- Bulbena, A., Gago, J., Pailhez, G., Sperry, L., Fullana, M. A., & Vilarroya, O.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Corresponding author
- Pailhez, Guillem
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 33
- Issue
- 4
- Pages
- 363-370
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2002588000
- Cited by
- 113
- References
- 36
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 6 · 2020: 7 · 2019: 7 · 2018: 2 · 2017: 12 · 2016: 6 · 2015: 14 · 2014: 16 · 2013: 8 · 2012: 5
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- joint hypermobility syndrome, anxiety disorders, panic disorder, agoraphobia, social anxiety disorder, specific phobia, Beighton criteria, risk factors
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Female, Follow-Up Studies, Humans, Joint Instability, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk Factors, Spain, Cohort Studies, Epidemiologic Studies, Young Adult
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