The DOI matches its Crossref record; 35 of the 36 references it cites were found in a registry or an index.
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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
In the citing paper
“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 the citing paper
“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]
In the citing paper
“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]
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1 of the 36 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Rotés, 1957, La laxitud articular como factor de alteraciones del aparato locomotor, Rev Esp Reumatol, 1, 59
- Bulbena, 2004, Anxiety disorder and joint laxity: a definitive link., Neurol Psychiatry Brain Res, 11, 137
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Jari, M., & Alesaeidi, S. (2025) · Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders · doi:10.1177/11795441251365672
The emotional state in benign joint hypermobility syndrome and associated factors
Em, S. (2014) · Dicle Medical Journal / Dicle Tip Dergisi · doi:10.5798/diclemedj.0921.2014.04.0497
Revista Brasileira de Psiquiatria
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Associação entre ansiedade e hipermobilidade articular: estudos com diferentes amostras
Sanches, S. B. (2014) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.17.2014.tde-04112014-193538
Diagnostic procedures for fascial elasticity
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Metadata
- 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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