Joint hypermobility and anxiety: the state of the art.

Joint hypermobility (JH) is considered a common benign, hereditary, overlap, connective tissue disorder with a prevalence in the general population of about 10% in European populations and 25% in other ethnic groups. JH shows an association with mitral valve prolapse and fibromyalgia. However, the most significant and important association between joint hypermobility syndrome (JHS) and any other disorder from a clinical point of view is with panic disorder. This article summarizes all published studies on JHS and anxiety, analyzing the main results and limitations. An overview of the etiologic explanation of the association between JH and anxiety, with special focus on genetic findings, is also included. The most relevant conclusions are the following: JHS is more prevalent in individuals with panic disorder/agoraphobia, and patients with JHS present with greater prevalence of panic disorder/agoraphobia. In addition, there is an association between JHS severity and severity of anxiety, and mitral valve prolapse plays a secondary role in the association between JHS and anxiety. New fields of research based on these data are suggested.

Association between joint hypermobility syndrome and panic disorder: a case-control study.

BACKGROUND: A significant association between joint hypermobility syndrome (JHS) and panic disorder was observed in a sample of rheumatology outpatients. OBJECTIVE: The aim of this study was to assess whether JHS is more frequent in panic-disorder than in control subjects. METHOD: The authors conducted a case-control study comparing 55 untreated patients with panic disorder and three matched-control groups: psychiatric patients, fibromyalgia patients, and healthy persons. RESULTS: JHS was more frequent among panic-disorder than among psychiatric patients, the healthy group, or the fibromyalgia group. In the panic-disorder group, there was a significant correlation between severity of JHS and anxiety. CONCLUSION: The strong association between JHS and panic disorder points to a genetic association. There is also a possibility that JHS and mitral valve prolapse, another condition frequently associated with panic disorder, share a common pathophysiological mechanism.