Joint hypermobility in functional neurological disorder: A cross-sectional study

Functional Neurological Disorder (FND) is associated with anxiety and depression, and perhaps with joint hypermobility, which is itself associated with anxiety and depression. We conducted a survey to explore the relationship between these.

An online survey of people with FND was conducted, with participants asked to nominate healthy controls from their social group to join. Participants were asked about their anxiety (measured with GAD7), depression (measured with PHQ9) and joint hypermobility (measured with 5PQ). A regression analysis was conducted using a general linear model.

215 people with FND and 22 people without FND were included in the analysis. GAD7, PHQ9 and hypermobility scores were all higher in the group with FND, with 74% of people with FND meeting the common cut-off for a diagnosis of joint hypermobility syndrome, as compared with 45% of those without FND. Anxiety, depression and joint hypermobility scores all predicted FND status, with joint hypermobility the strongest. Hypermobility moderated the effect of anxiety, with the effect being stronger at lower levels of anxiety.

While anxiety, depression and hypermobility symptoms each appear to contribute to FND, the role of anxiety is moderated by hypermobility, particularly when anxiety is lower.