title: Joint hypermobility syndrome is a risk factor trait for anxiety disorders: a 15-year follow-up cohort study.
abstract: OBJECTIVE
  The objective of the study was to assess whether joint hypermobility syndrome (JHS) is a risk factor for developing anxiety disorders using a 15-year prospective cohort study.
  
  
  METHODS
  The initial cohort recruited 158 subjects aged 16 to 20 years from the general population in a Spanish rural town. The cohort was studied at baseline and at a 15-year follow-up. Joint hypermobility syndrome was assessed using Beighton's criteria, and the psychiatric disorders were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders. Subjects with anxiety disorders at baseline were excluded from the follow-up.
  
  
  RESULTS
  Joint hypermobility syndrome at baseline was found in 29 of 158 subjects (21.1%). Cumulative incidence of panic/agoraphobia disorder at follow-up, as main diagnosis, was significantly higher for the JHS group (41.4%) than for the control group (1.9%), with a relative risk of 22.3 [95% confidence interval (CI) 4.6-108.7, P<.0001] (Number Needed to Treat [NNT] 3, 95% CI 2.9-2.3). Incidence of social phobia and simple phobia was also significantly higher for the JHS group [relative risk (RR)=6.52, 95% CI 1.7-24.2, P<.001 and RR=3.31, 95% CI 1.1-9.6, P=.02, respectively]. Moreover, anxiolytic drug use was nearly fourfold higher among JHS compared to non-JHS subjects.
  
  
  CONCLUSIONS
  Joint hypermobility syndrome was associated with higher risk of developing anxiety disorders. If replicated, these findings may give enhanced value to JHS assessment in clinical and general population studies.
authors.affiliation: Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Bulbena
authors.forename: Jordi
authors.initials: J
authors.lastname: Gago
authors.forename: Guillem
authors.initials: G
authors.lastname: Pailhez
authors.forename: Lili
authors.initials: L
authors.lastname: Sperry
authors.forename: Miquel A
authors.initials: MA
authors.lastname: Fullana
authors.forename: Oscar
authors.initials: O
authors.lastname: Vilarroya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis*; D015331:Cohort Studies; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult