title: Joint hypermobility and the heritable disorders of connective tissue: clinical and empirical evidence of links with psychiatry.
abstract: OBJECTIVE
  The heritable disorders of connective tissue (HDCTs) are a group of genetic disorders affecting connective tissue matrix proteins. Fragility, laxity of tissues and joint hypermobility (JH) are commons features of HDCT for which the prognosis may range from benign to life threatening. JH and HDCTs, especially joint hypermobility syndrome, Ehlers-Danlos syndromes and Marfan syndrome, have been associated with psychiatric symptomatology. We explored the existing knowledge concerning this association in order to provide an overview of mental disorders linked to JH/HDCT, as well as the hypotheses proposed to explain such association.
  
  
  METHODS
  A comprehensive search of scientific online databases and references lists was conducted, encompassing publications based on quantitative and qualitative research, including case reports.
  
  
  RESULTS
  Psychiatric conditions in which there is some evidence of an association with JH/HDCT are anxiety disorders, depression, schizophrenia, neurodevelopmental disorders (autism, attention deficit/hyperactivity disorder, and developmental coordination disorder), eating disorders, personality disorders and substance use/misuse.
  
  
  CONCLUSIONS
  Despite the need of more research, the available data highlight the importance of examining psychiatric symptoms in those affected by JH/HDCT and the importance of providing interventions with a multidisciplinary approach. The relationship between JH/HDCT and mental disorders merits further attention in order to improve current knowledge and clarify a possible common etiology.
authors.affiliation: Department of Child and Adolescent Psychiatry, CHU Montpellier, France; Institut de Psychologie, Université Paris Descartes, Sorbonne Paris Cité, France. Electronic address: carolina.baeza-velasco@parisdescartes.fr.
authors.forename: Carolina
authors.initials: C
authors.lastname: Baeza-Velasco
authors.affiliation: Anxiety Unit-Institut de Neuropsiquiatria i Addicions (INAD), Hospital del Mar, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Pailhez
authors.affiliation: Anxiety Unit-Institut de Neuropsiquiatria i Addicions (INAD), Hospital del Mar, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bulbena
authors.affiliation: Department of Child and Adolescent Psychiatry, CHU Montpellier, France; Laboratory Epsylon (EA 4556), University of Montpellier, France.
authors.forename: Amaria
authors.initials: A
authors.lastname: Baghdadli
mesh_terms: D015897:Comorbidity; D003240:Connective Tissue Diseases / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology* / Q000235:genetics; D001523:Mental Disorders / Q000453:epidemiology*
keywords: Ehlers–Danlos; Hereditary disorders of the connective tissue; Joint hypermobility; Marfan; Psychiatric disorders