Abstract
Joint hypermobility syndrome (JHS), also known as Ehlers–Danlos III, is an inherited disorder of connective tissue, characterised by an exceptional increase in the joint’s mobility and the presence of musculoskeletal and other symptoms. It is a benign syndrome if compared with the other types of Ehlers–Danlos, but it can become disabling particularly because it is a significant source of pain and distress. The purpose of this work is to describe some common problems in JHS that render psychological intervention in their overall management relevant. Chronic pain, associated psychopathological factors such as anxiety, depression and somatosensory amplification, and problems arising from a lack of recognition and knowledge of the syndrome, are frequent among those affected, having a negative impact on their quality of life. We emphasise the relevance of addressing JHS from a biopsychosocial approach.
Similar content being viewed by others
References
Hakim A, Grahame R (2003) Joint hypermobility. Best Pract Res Clin Rheumatol 17:989–1004
Simpson MR (2006) Bening joint hypermobility syndrome: evaluation, diagnosis and management. J Am Osteopath Assoc 106:531–536
Bulbena A, Duró J, Mateo A, Porta M, Vallejo J (1988) Joint hypermobility syndrome and anxiety disorders (letter). Lancet 2(8612):694
Baeza-Velasco C, Bulbena A (2010) The relationship between anxiety and joint hypermobility: literature review. Annales Médico Psychologiques 168:263–267
Bulbena A, Benito P, Pailhez G, Gago J, Carbonell J, Sperry L et al (2004) Hiperlaxitud Articular, definición y exploración. Programa interactivo de formación [Cd rom]. Institut d’Atenció Psiquiàtrica Salud Mental i Toxicomanies Hospital del Mar, Barcelona
Bravo J, Wolff C (2006) Clinical study of hereditary disorders of connective tissues in a Chilean population. Joint hypermobility syndrome and vascular Ehlers–Danlos syndrome. Arthritis Rheum 54:515–523
Gumà M, Olivé A, Holgado S, Casado E, Roca J, Forcada J et al (2001) Una estimación de la laxitud en la consulta externa. Rev Esp Reumatol 28:298–300
Grahame R (2003) Hypermobility and hypermobility syndrome. In: Keer R, Grahame R (eds) Hypermobility syndrome, recognition and management for physiotherapist. Butterworth Heinemann, New York, pp 1–15
Grahame R (2006) Pain, distress and joint hyperlaxity. Joint Bone Spine 67:157–163
Bravo J. pain in the joint hypermobility syndrome (JHS). [homepage on the Internet]. Available from http://www.reumatologia-dr-bravo.cl/patients/PainJHS.htm
Breivik H, Collet B, Ventafridda V, Cohen R, Gallacher A (2006) Survey of chronic pain in Europe: prevalence, impact of daily life, and treatment. Eu J Pain 10:287–333
Herrero AM, Ramirez-Maestre C, Gonzalez V (2008) Personality, cognitive appraisal and adjustment in chronic pain patients. Span J Psychol 11:531–542
Moix J, Kovacs FM (2009) Manual del dolor. Tratamiento cognitivo conductual del dolor crónico. Paidos, Barcelona
Harding V, Grahame R (1990) The frequency of joint hypermobility syndrome in chronic pain patients. Pain 5(Suppl):S500
Harding V (2003) Joint hypermobility and chronic pain: possible linking mechanisms and management highlighted by a cognitive-behavioural approach. In: Keer R, Grahame R (eds) Hypermobility Syndrome, Recognition and Management for Physiotherapist. Butterworth Heinemann, New York, pp 147–161
Keefe FJ (1996) Cognitive behavioral therapy for managing pain. Clin Psychol 49:4–5
Tison P, Hautekeete M, Bardiaux C, Roussez A (2009) Croyances dans la douleur chronique. Journal de Thérapie Comportementale et Cognitive 19:67–71
Turk D, Rudy T (1992) Cognitive factors and persistent pain. Cognit Ther Res 16:99–122
Gurley-Green S (2001) Living with the hypermobility syndrome. Rheumathology 40:487–489
López-Espino M, Mingote-Adan JC (2009) El dolor crónico desde la perspectiva psicosomática. C Med Psicosom 89(90):47–57
Chassot P, Piguet V, Remund C, Luthy C, Cedraschi C (2006) Douleurs chroniques et thérapie cognitivo-comportamentale de groupe. Le Courrier de l’algologie 5:7–10
Baeza-Velasco C (2010) Síntoma orgánico vs. Síntoma psicosomático (Editorial). Cuad Neuropsicol 4:8–15
Grahame R (2000) Heritable disorders of connective tissue. Baillieres Best Pract Res Clin Rheumatol 14:345–361
Ridout K. Management of the joint hypermobility syndrome: anxiety, depression, and chronic pain, in Joint hypermobility syndrome: a complex constellation of symptoms [document on the Internet]. Available from http://www.medscape.com/viewarticle/537938
Bulbena A, Gago J, Sperry L, Berge D (2006) The relationship between frequency and intensity of fears and collagen condition. Depress Anxiety 23:412–417
Gülsün M, Doruk A, Uzun O, Tonbul M (2006) Eklem hipermobilite sendromu olan klinic disi erkek örnekleminde anksiyete bozukluklari. Yeni Symp J 44:165–168
Gülsün M, Yilmaz MB, Pinar M, Tonbul M, Celik C, Ozdemir B et al (2007) Thorax deformity, joint hypermobility, and anxiety disorders. Saudi Med J 28:1840–1844
Martín-Santos R, Bulbena A, Porta M, Gago J, Molina L, Duró JC (1998) Association between joint hypermobility syndrome and panic disorder. Am J Psychiatry 155:1578–1583
Baeza-Velasco C, Bulbena A, Bravo JF (2010) Anxious symptomatology and Joint hypermobility syndrome (JHS) in a group of Chilean undergraduate students. Ansiedad y Estrés 16:1–12
Gratacòs M, Nadal M, Martín-Santos R, Pujana MA, Gago J, Peral B et al (2001) A polymorphic genomic duplication on human chromosome 15 is a susceptibility factor for panic and phobic disorders. Cell 106:367–379
Schumacher J, Otte A, Becker T, Sun Y, Wienker T, Wirth B et al (2003) No evidence for DUP25 in patients with panic disorder using a quantitative real-time PCR approach. Hum Genet 114:115–117
Tabiner M, Youings S, Dennis N, Baldwin D, Buis C, Mayers A et al (2003) Failure to find DUP25 in patients with anxiety disorders, in control individuals, or in previously reported positive control cell lines. Am J Hum Gen 72:535–538
Fishbain D, Cutler R, Rosomoff H, Rosomoff R (1997) Chronic pain-associated depression: antecedent or consequence of chronic pain? A review. Clin J Pain 13:116–137
Baeza-Velasco C, Gély-Nargeot MC, Bulbena A, Fénétrier C, Bravo JF Association between psychopathological factors and joint hypermobility syndrome in a group of undergraduates from a French university. Int J Psychiatr Med (in press)
Ercolani M, Galvani M, Franchini C, Baracchini F, Chattat R (2008) Bening joint hypermobility syndrome: psychological features and psychopathological symptoms in a sample pain-free at evaluation. Percep Mot Skills 107:246–256
Kirk JH, Ansell BA, Bywaters EG (1967) The hypermobility syndrome. Ann Rheum Dis 26:419–425
Bravo J (2008) Significado e importancia de estudiar a las personas con hiperlaxitud articular. Revista Chilena de Reumatología 24:4–5
Grahame R, Bird HA, Child A (2000) The British Society for Rheumatology Special Interest Group on heritable disorders of connective tissue criteria for the benign joint hypermobility syndrome. The revised (Brighton 1998) criteria for the diagnosis of BJHS. J Rheumatol 27:1777–1779
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Baeza-Velasco, C., Gély-Nargeot, M.C., Bulbena Vilarrasa, A. et al. Joint hypermobility syndrome: problems that require psychological intervention. Rheumatol Int 31, 1131–1136 (2011). https://doi.org/10.1007/s00296-011-1839-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-011-1839-5