title: Self-reported quality of life, anxiety and depression in individuals with Ehlers-Danlos syndrome (EDS): a questionnaire study.
abstract: BACKGROUND
  Many individuals with Ehlers-Danlos Syndrome (EDS) are hypermobile, suffer from long term pain, and have complex health problems. Since these sometimes have no objective physical signs, individuals with EDS sometimes are referred for psychiatric evaluation. The aim was therefore to identify the level of anxiety and quality of life in a Swedish group of individuals with EDS.
  
  
  METHODS
  A postal survey in 2008 was distributed to 365 members over 18 years of the Swedish National EDS Association and 250 with EDS diagnosis responded. Two questionnaires, the Hospital Anxiety and Depression Scale (HADS) and SF-36, were used. A Swedish population study was used to compare results from SF-36. Independent Student's t-test was used to compare differences between groups, possible relationships were tested using Spearman's correlation coefficient and the General Linear Model was used for regression analyses. Higher scores on HADS represent higher levels of anxiety and depression and higher scores on SF-36 represent higher quality of health.
  
  
  RESULTS
  Of the respondents 74.8% scored high on anxiety and 22.4% scored high on depression on the HADS. Age, tiredness and back pain was independently associated with the HAD anxiety score in a multiple regression analysis, When comparing the SF-36 scores from the EDS group and a Swedish population group, the EDS group scored significantly lower, indicating lower health-related quality of health than the general population (p < 0.001).
  
  
  CONCLUSIONS
  In comparison with a Swedish population group, a lower health-related quality of life was found in the EDS group. Also, higher levels of anxiety and depression were detected in individuals with EDS. The importance to explore the factors behind these results and what initiatives can be taken to alleviate the situation for this group is emphasized.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. briber30@gmail.com.
authors.forename: Britta
authors.initials: B
authors.lastname: Berglund
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. carina.pettersson@pubcare.uu.se.
authors.forename: Carina
authors.initials: C
authors.lastname: Pettersson
authors.affiliation: Department of Immunology, Genetics and Pathology, Section of Clinical Genetics, Uppsala University Hospital, Uppsala, Sweden. maritta.hellstrom.pigg@akademiska.se.
authors.forename: Maritta
authors.initials: M
authors.lastname: Pigg
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. per.kristiansson@pubcare.uu.se.
authors.forename: Per
authors.initials: P
authors.lastname: Kristiansson
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004535:Ehlers-Danlos Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology