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Association between joint hypermobility syndrome and panic disorder
R Martín-Santos1, A Bulbena, M Porta
1Department of Psychiatry, Hospital del Mar, Barcelona, Spain.
The American Journal of Psychiatry
|November 13, 1998
Summary
Patients with panic disorder or agoraphobia have significantly higher rates of joint hypermobility syndrome. This increased joint laxity appears to be a constitutional factor, with mitral valve prolapse playing a minor role.
Area of Science:
- Psychiatry
- Rheumatology
- Cardiology
Background:
- Panic disorder and agoraphobia are common anxiety disorders.
- Joint hypermobility syndrome (JHS) is a condition characterized by excessive joint flexibility.
- The potential link between anxiety disorders and JHS requires further investigation.
Purpose of the Study:
- To determine if JHS is more prevalent in patients with panic disorder, agoraphobia, or both compared to controls.
- To investigate whether mitral valve prolapse (MVP) influences the association between JHS and anxiety disorders.
Main Methods:
- A case-control study involving 99 patients with anxiety disorders and two control groups (99 psychiatric, 64 medical).
- Diagnosis of JHS using Beighton's criteria and anxiety disorders via Structured Clinical Interview for DSM-III-R.
- Echocardiograms were used to assess for MVP. Raters were blinded to psychiatric status.
Main Results:
- JHS was present in 67.7% of anxiety disorder patients versus 10.1% (psychiatric controls) and 12.5% (medical controls).
- Anxiety disorder patients were over 16 times more likely to have joint laxity, independent of MVP.
- Anxiety patients with JHS were younger, more often female, and had an earlier onset of their disorder.
Conclusions:
- High prevalence of joint laxity in panic disorder and agoraphobia suggests a potential constitutional predisposition to anxiety.
- Mitral valve prolapse appears to play a secondary role in the observed association between JHS and anxiety.