Managing hypermobility spectrum disorder in a psychiatric setting

This case highlights the intersection of psychiatric symptoms and hypermobility spectrum disorder (HSD) in a woman in her 20s with multiple comorbidities, including postural orthostatic tachycardia syndrome, chronic pain and obstructive sleep apnoea. The patient had been unresponsive to conventional psychiatric treatments for anxiety and panic attacks. On recognition of HSD, a multidisciplinary approach, including propranolol for autonomic dysfunction, pregabalin for pain and anxiety, and lisdexamfetamine for cognitive impairment, significantly improved her condition. Early identification and tailored management of HSD in psychiatric settings can optimise treatment outcomes by addressing both physical and psychiatric symptoms. This case underscores the need for psychiatrists to incorporate physical health assessments into their diagnostic processes when treating complex psychiatric presentations.