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Unexpected association between joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type and obsessive–compulsive personality disorder

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Abstract

Joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type (JHS/EDS-HT) is a largely unrecognized, heritable connective tissue disorder, mainly characterized by joint instability complications, widespread musculoskeletal pain, and minor skin features. In a case–control study, 47 consecutive JHS/EDS-HT patients were investigated for the prevalence of psychiatric disorders and compared to 45 healthy controls in a single center. The psychiatric evaluation consisted of structured clinical interview for DSM-IV criteria by using the SCID-I and the SCID-II. Symptom severity was assessed using the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), and the Brief Psychiatric Rating Scale (BPRS). The Global Assessment of Functioning Scale (GAF) was used to assess the overall severity of psychological, social, and occupational functions. JHS/EDS-HT patients had significantly higher mean scores for all questionnaires: HAM-A (6.7 vs. 3.8), HAM-D (6.4 vs. 2.7), GAF (75.0 vs. 86.1), and BPRS (27.5 vs. 25.6). The JHS/EDS-HT group had a 4.3 higher risk of being affected by any psychiatric disorder, and in particular, a 5.8 higher risk of having a personality disorder. In particular, 5 JHS/EDS-HT suffered from obsessive–compulsive personality disorder with an observed prevalence rate of 10.6 % (3.6–23.1). Psychiatric assessment of JHS/EDS-HT patients showed an extremely high prevalence of personality disorders (21 %), and of Axis-I disorders (38 %), mostly depressive. This study did not confirm the previously reported increased rate of panic disorders in JHS/EDS-HT.

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Authors and Affiliations

  1. Department of Neurology and Psychiatry, Umberto I Hospital, Sapienza University of Rome, Rome, Italy

    Massimo Pasquini, Isabella Berardelli, Valentina Roselli & Massimo Biondi

  2. Physical Medicine and Rehabilitation Division, Umberto I Hospital, Sapienza University of Rome, Rome, Italy

    Claudia Celletti & Filippo Camerota

  3. Clinical Epidemiology Unit, IDI-IRCSS, Rome, Italy

    Simona Mastroeni

  4. Division of Medical Genetics, Department of Molecular Medicine, San Camillo-Forlanini Hospital, Sapienza University of Rome, Rome, Italy

    Marco Castori

Authors
  1. Massimo Pasquini
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  2. Claudia Celletti
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  3. Isabella Berardelli
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  4. Valentina Roselli
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  5. Simona Mastroeni
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  6. Marco Castori
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  7. Massimo Biondi
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  8. Filippo Camerota
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Correspondence to Claudia Celletti.

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Pasquini, M., Celletti, C., Berardelli, I. et al. Unexpected association between joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type and obsessive–compulsive personality disorder. Rheumatol Int 34, 631–636 (2014). https://doi.org/10.1007/s00296-013-2901-2

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  • DOI: https://doi.org/10.1007/s00296-013-2901-2

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