Copyright
©The Author(s) 2021.
World J Psychiatr. Oct 19, 2021; 11(10): 805-820
Published online Oct 19, 2021. doi: 10.5498/wjp.v11.i10.805
Published online Oct 19, 2021. doi: 10.5498/wjp.v11.i10.805
Table 1 Indications prompting screening for hypermobility spectrum disorders/hypermobile Ehlers-Danlos syndrome amongst patients presenting to mental health services (adapted from Ross and Grahame 2011[102])
Extra-articular features | Articular features | |
In children and adolescents | Prolonged fatigue or tiring easily | Joint dislocations/subluxations (including congenital hip dislocation) |
Poor motor coordination or ‘clumsiness’ (such as poor ball catching and poor handwriting) | Recurrent ankle sprains | |
Chronic widespread pain or ‘growing pains’ | ||
Delayed walking, with bottom shuffling instead of crawling | ||
In adults | Prolonged unexplained fatigue (including ME/CFS) | Recurrent joint dislocations |
Chronic widespread pain, particularly if unresponsive to analgesia (including fibromyalgia) | Multiple soft tissue injuries/rheumatisms | |
Functional gastrointestinal disorders (such as IBS, functional dyspepsia, constipation) | Premature osteoarthritis | |
Autonomic dysfunction (such as orthostatic intolerance or PoTS) | Persistent or recurrent joint pains | |
Progressive loss of mobility secondary to pain or pain-avoidance strategies | ||
Laxity in supporting tissues (such as hernias, varicose veins, pelvic floor dysfunction) | ||
Soft/hyperextensible skin, unexplained striae, easy bruising |
Table 2 Five-point screening questionnaire for detecting hypermobility (from Hakim and Grahame 2003[1])
1 Can you now (or could you ever) place your hands flat on the floor without bending your knees? |
2 Can you now (or could you ever) bend your thumb to touch your forearm? |
3 As a child, did you amuse your friends by contorting your body into strange shapes OR could you do the splits? |
4 As a child or teenager did your shoulder or kneecap dislocate on more than one occasion? |
5 Do you consider yourself ‘double-jointed’? |
Answering yes to two or more questions suggests hypermobility with sensitivity 80%-85% and specificity 80%-90% |
- Citation: Sharp HEC, Critchley HD, Eccles JA. Connecting brain and body: Transdiagnostic relevance of connective tissue variants to neuropsychiatric symptom expression. World J Psychiatr 2021; 11(10): 805-820
- URL: https://www.wjgnet.com/2220-3206/full/v11/i10/805.htm
- DOI: https://dx.doi.org/10.5498/wjp.v11.i10.805