Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry

Baeza-Velasco, Carolina; Pailhez, Guillem; Bulbena, Antonio; Baghdadli, Amaria

doi:10.1016/j.genhosppsych.2014.10.002

Cited by 67Connective tissue disorders researchOral and gingival health researchPsychosomatic Disorders and Their Treatments

Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry

Baeza-Velasco, Carolina, Pailhez, Guillem, Bulbena, Antonio, Baghdadli, Amaria·2015·General Hospital Psychiatry

DOI 10.1016/j.genhosppsych.2014.10.002

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Abstract

Objective The heritable disorders of connective tissue (HDCTs) are a group of genetic disorders affecting connective tissue matrix proteins. Fragility, laxity of tissues and joint hypermobility (JH) are commons features of HDCT for which the prognosis may range from benign to life threatening. JH and HDCTs, especially joint hypermobility syndrome, Ehlers-Danlos syndromes and Marfan syndrome, have been associated with psychiatric symptomatology. We explored the existing knowledge concerning this association in order to provide an overview of mental disorders linked to JH/HDCT, as well as the hypotheses proposed to explain such association. Method A comprehensive search of scientific online databases and references lists was conducted, encompassing publications based on quantitative and qualitative research, including case reports. Results Psychiatric conditions in which there is some evidence of an association with JH/HDCT are anxiety disorders, depression, schizophrenia, neurodevelopmental disorders (autism, attention deficit/hyperactivity disorder, and developmental coordination disorder), eating disorders, personality disorders and substance use/misuse. Conclusion Despite the need of more research, the available data highlight the importance of examining psychiatric symptoms in those affected by JH/HDCT and the importance of providing interventions with a multidisciplinary approach. The relationship between JH/HDCT and mental disorders merits further attention in order to i…

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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 [17]
Generalised joint hypermobility (GJH) is a characteristic marker of hereditary disorders of connective tissue, compromising a matrix of proteins including collagens, elastins, fibrillins and tenascins.
“Generalised joint hypermobility (GJH) is a characteristic marker of hereditary disorders of connective tissue, compromising a matrix of proteins that includes collagens, elastins, fibrillins and tenascins.5”
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 [5]
ASD and joint hypermobility-related disorders co-occur more often than expected by chance.
“a scarce but growing body of research suggesting that both conditions co-occur more often than expected by chance.”
From Autism, joint hypermobility-related disorders and pain (2018) · cites this paper as [22]
Eight case reports have been published concerning the potential association between ASD and EDS.
“Moreover, to date eight case reports have been published concerning the potential association between ASD and EDS (22, 46, 47).”
From Autism, joint hypermobility-related disorders and pain (2018) · cites this paper as [22]

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Interoception in autism Spectrum disorder: a review
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“Further, other psychiatric disorders have been implicated in EDS [9].”
Background
Psychiatric disorders in Ehlers-Danlos syndrome are frequent, diverse and strongly associated with pain
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Self-citation
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Self-citation
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Connecting brain and body: Transdiagnostic relevance of connective tissue variants to neuropsychiatric symptom expression
Sharp, H. E. C., Critchley, H. D., & Eccles, J. A. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i10.805 · Cited by 32 · see citing works
Ehlers-Danlos Syndrome in the Field of Psychiatry: A Review
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A connective tissue disorder may underlie ESSENCE problems in childhood
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Symptom complaints and impact on functioning in youth with hypermobile Ehlers–Danlos syndrome
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The effects of acute and elective cardiac surgery on the anxiety traits of patients with Marfan syndrome
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Variant connective tissue (joint hypermobility) and its relevance to depression and anxiety in adolescents: a cohort-based case–control study
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A cohort study comparing women with Autism Spectrum Disorder with and without generalized joint hypermobility
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Neurodevelopmental atypisms in the context of joint hypermobility, hypermobility spectrum disorders, and < scp>Ehlers–Danlos < /scp> syndromes
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Self-citation
An acquired or heritable connective tissue disorder? A review of hypermobile Ehlers Danlos Syndrome
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Psychosocial and Motor Characteristics of Patients With Hypermobility
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Immune, Autonomic, and Endocrine Dysregulation in Autism and Ehlers-Danlos Syndrome/Hypermobility Spectrum Disorders Versus Unaffected Controls
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Ehlers-Danlos Syndromes
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“…psychiatric disorders and psychosocial impairment are also common among individuals with EDS and HSD. Specifically, 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].”
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Незнанов, Н. Г., Rukavishnikov, G. V., Kaysanov, E. D., Zhilyaeva, T. V., & Mazo, G. E. (2020) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2020-3-3-10 · Cited by 8 · see citing works
Prevalence of psychiatric and sleep disorders and their impact on quality of life in children with hypermobile Ehlers-Danlos syndrome: an observational study
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Do Influential Articles on the Genetics of Autism Show Evidence of Engagement With the Autistic Community?
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Hypermobility spectrum disorders and active migraine in Israeli adolescents: A nationwide study
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A new conceptual model for anorexia nervosa: A role for connective tissue?
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Neurobiological and neuropsychological disturbance in EDS
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Treatment of Severe Emotionally Unstable Personality Disorder with Comorbid Ehlers-Danlos Syndrome and Functional Neurological Disorder in an Inpatient Setting: A Case for Specialist Units without Restrictive Interventions
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The Neuroconnective Endophenotype, a New Approach Toward Typing Functional Neurological Disorder: A Case-Control Study
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Corneal structural alterations in autism spectrum disorder: An in vivo confocal microscopy study
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Joint Hypermobility, Anxiety, and Psychosomatics — The New Neuroconnective Phenotype
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The impact of generalized joint hypermobility on eating behavior of students: A case-control study
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Likely neurodivergence and variant connective tissue in patients with chronic pain/chronic fatigue: a case-control study
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The investigation of foot structure within children who have attention-deficit hyperactivity disorder: a case-controlled study
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Balance in patients with Marfan syndrome
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Anxiety Disorders in the Autism Spectrum: Update and Multi-Case–Control Study on Clinical Phenotypes
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Inherited Metabolic Diseases as a Multisystem Model of Mental Disorders Research
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Associations Between Pain and Substance Use Among Individuals Diagnosed with Ehlers-Danlos Syndromes or Generalized Hypermobility Spectrum Disorder
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Joint hypermobility and its relevance to common mental illness in adolescents: a population-based longitudinal study
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Comorbid Bipolar Disorder and Benign Joint Hyper Mobility Syndrome (BJHS): More than a Mere Coincidence?
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Psychiatric Manifestations of Ehlers-Danlos Syndrome in Adolescents: A Case Report and Literature Review
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E210 施設抑制ミニトマト栽培における総合的害虫管理とその経営的評価(防除法害虫管理 IPM)
杉山, 恵., 片山, 晴., & 西東, 力. (2004) · 日本応用動物昆虫学会大会講演要旨
The cooccurrence of psychosis and Marfanoid features: diagnostic considerations
Colijn, M. A. (2022) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-022-01404-w
Author reply
Hall, J. (2018) · The British Journal of Psychiatry · doi:10.1192/bjp.2018.127
Hypermobility
Basel, D. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-76174-1.00047-x
CONTENT AND COMPOSITION OF FREE AND BOUND AMINO ACIDS IN THE URINE OF CHILDREN WITH UNDIFFERENTIATED CONNECTIVE TISSUE SYNDROME LIVING IN THE REPUBLIC OF SAKHA (YAKUTIA)
Nokhsorova, M., Борисова, Н. В., & Михайловна, А. А. (2022) · Bulletin Biomedicine and sociology · doi:10.26787/nydha-2618-8783-2022-7-4-12-21
Joint Hypermobility Syndrome: 2 Cases from the Capital of the Cherokee Nation and Review of Literature
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Kacperczyk, J., Czyż, W., Wójcikiewicz, M., Arczewski, F., Dziedzic, K., Kulbacka, J., Wojszczyk, M., Zys, D., Pasek, P., & Ryniecka, J. (2025) · Quality in Sport · doi:10.12775/qs.2025.37.57296
Understanding the Neuropsychological Profile of Autism Spectrum Disorder
Thacker, R. (2025) · IGI Global eBooks · doi:10.4018/979-8-3693-9689-6.ch010
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Quadt, L., Savage, G. K., Bond, R., Davies, K. A., Critchley, H., & Eccles, J. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5381277
Parasympathetic and Sympathetic Nervous System Dysfunction and Monitoring
DePace, N. L., Soloway, S., Yayac, M. F., & Colombo, J. (2025) · Springer eBooks · doi:10.1007/978-3-031-88769-7_13

Connecting brain and body: Transdiagnostic relevance of connective tissue variants to neuropsychiatric symptom expression
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EPA-1328 - Psychiatric comorbidities in the joint hypermobility syndrome/ehlers danlos syndrome hypermobility type
Roselli, V., Pasquini, M., Celletti, C., Berardelli, I., Mastroeni, S., Castori, M., Biondi, M., & Camerota, F. (2014) · European Psychiatry · doi:10.1016/s0924-9338(14)78546-3
<b>Psychopathological manifestations of joint hypermobility and joint hypermobility syndrome/ Ehlers–Danlos syndrome, hypermobility type:</b> The link between connective tissue and psychological distress revised
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Unexpected association between joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type and obsessive–compulsive personality disorder
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Joint hypermobility syndrome. Psychiatric manifestations
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Authors: Baeza-Velasco, C., Pailhez, G., Bulbena, A., & Baghdadli, A.
Affiliations: Hospital Del Mar (ES)
Université de Montpellier (FR)
ORCID: Pailhez, Guillem
Bulbena, Antonio
Baghdadli, Amaria
Venue: General Hospital Psychiatry
Publisher: Elsevier BV
Published: 2015-01
Volume: 37
Issue: 1
Pages: 24-30
ISSN: 0163-8343 (ISSN-L)
DOI: 10.1016/j.genhosppsych.2014.10.002
OpenAlex: W1991092640
Cited by: 67
References: 101
Citations by year: 2026: 1 · 2025: 9 · 2024: 2 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 6 · 2019: 6 · 2018: 8 · 2017: 3 · 2016: 3 · 2015: 4
FWCI: 0.44
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: General Hospital Psychiatry (publishedVersion)
PubMed (publishedVersion)
HAL (submittedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
Health Sciences › Health Professions › Pharmacy › Oral and gingival health research
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: joint hypermobility, Ehlers-Danlos syndrome, Marfan syndrome, joint hypermobility syndrome, psychiatric comorbidity, anxiety disorders, depression, schizophrenia, neurodevelopmental disorders, autism spectrum disorder, attention deficit hyperactivity disorder, developmental coordination disorder, eating disorders, personality disorders, substance use disorders, multidisciplinary care
MeSH terms: Mental Disorders, Connective Tissue Diseases, Humans, Joint Instability, Comorbidity

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Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry

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