Pain, gastrointestinal dysfunction, psychiatric disorders with EDS

Pain and gastrointestinal dysfunction are significant associations with psychiatric disorders in patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders – PubMed – NCBI – Mar 2019

Unfortunately, we don’t have access to the full article, but even the abstract shows that EDS is a systemic dysfunction. Symptoms show up in various bodily systems, leading to both physical and mental health problems.

In this retrospective study, we investigate the frequency and types of psychiatric disorders and their relationship to systemic manifestations in a cohort of 391 Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorder (HSD) patients based on the current 2017 International Classification of EDS diagnostic criteria.  

A detailed, systematic retrospective chart review was undertaken for patients assessed for HSD or EDS at two Canadian health centres.

Patients were diagnosed according to the Villefranche criteria and reclassified for this study according to the 2017 International Classification of EDS.

Data validation and statistical analyses were conducted.

Psychiatric disorders were very common, with

  • 49.4% of the total cohort affected;
  • 28.9% reported multiple psychiatric diagnoses.

Mood (34.5%) and somatoform (28.6%) disorders were most common.

Interestingly, attention-deficit/hyperactivity disorder (ADHD) was significantly enriched in the HSD, but not EDS cohort (p = 0.0002, 95% CI 3.48-9.00) compared to the general population.

There were no differences in the systemic associations with having psychiatric manifestations in the HSD compared to the EDS subsets.

Muscle/body pain (OR 1.99) and gastrointestinal dysfunction (OR 2.07) were significantly associated with having mood disorders, and gastrointestinal dysfunction (OR 2.61) and nerve-related pain (OR 3.27) were associated with having somatoform disorders across the cohort.

The common systemic associations with the presence of psychiatric manifestations in both HSD and EDS reaffirm that the conditions should be treated as a spectrum rather than as wholly separate entities, particularly with respect to psychiatric management.

EDS and HSD patients share common psychiatric presentations, though ADHD is more common with HSD.

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