Anxiety & Joint hypermobility : connecting mind and body

Abstract

Anxiety disorders are currently considered the most prevalent psychiatric illness across all ages and cause significant disability, which represent a burden to society. The nosology of anxiety disorders has changed significantly during the past centuries. While old concepts like neurosis embraced organic models of anxiety, in which symptoms of anxiety were interpreted in the context of medical illnesses, new nosological classification has moved towards the psychological, cognitive and behavioral aspects of anxiety. However, some studies reported the greatest proportion of the cost of anxiety is attributed to lost or reduced productivity, and the direct costs of medical treatment due to the unexplained physical or somatic symptoms. New models of somatic comorbidity among anxiety disorders have emerged over the past years and in this project, we focus on the relationship between the Joint Hypermobility Syndrome (also known as Ehlers Danlos-Hypermobile type (JHS/hEDS)) and Anxiety disorders, which was described for the first time over 30 years ago. We aimed to further study this association along with the underlying mechanisms with the ultimate goal of understanding the different dimensions of the psychopathology associated with JHS/hEDS. A literature reviews confirm an increasing amount of evidence pointing towards a high prevalence of psychiatric conditions among individuals with JHS/hEDS. Particularly, JHS/hEDS is strongly associated with anxiety and there is also limited but growing evidence that JHS/hEDS is also associated with depression, eating and neuro-developmental disorders as well as alcohol and tobacco misuse. In the area of anxiety disorders, clinical and nonclinical studies confirm the solid association between JHS and anxiety. Specifically, JHS has been found to be associated with higher frequency of the so-called endogenous anxiety disorders (panic disorders and agoraphobia) along with higher intensity of anxiety and fears and greater physical and somatic complaints. In one of the studies included in this thesis, we have proven that this association is also maintained in elderly populations.

Date of Award	17 Nov 2017
Original language	English
Supervisor	Thomas Wise (Director) & Antonio Bulbena Vilarrasa (Director)