Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers–Danlos syndrome or hypermobility syndrome and their siblings

Abstract

BackgroundTo assess the risk of psychiatric disorders in Ehlers-Danlos syndrome (EDS) and hypermobility syndrome.MethodsNationwide population-based matched cohort study. EDS, hypermobility syndrome and psychiatric disorders were identified through Swedish national registries. Individuals with EDS (n = 1,771) were matched with comparison individuals (n = 17,710). Further, siblings to individuals with EDS who did not have an EDS diagnosis themselves were compared with matched comparison siblings. Using conditional logistic regression, risk of autism spectrum disorder (ASD), bipolar disorder, attention deficit hyperactivity disorder (ADHD), depression, attempted suicide, suicide and schizophrenia were estimated. The same analyses were conducted in individuals with hypermobility syndrome (n = 10,019) and their siblings.ResultsEDS was associated with ASD: risk ratio (RR) 7.4, 95 % confidence interval (95 % CI) 5.2–10.7; bipolar disorder: RR 2.7, CI 1.5–4.7; ADHD: RR 5.6, CI 4.2–7.4; depression: RR 3.4, 95 % CI 2.9–4.1; and attempted suicide: RR 2.1, 95 % CI 1.7–2.7, but not with suicide or schizophrenia. EDS siblings were at increased risk of ADHD: RR 2.1, 95 % CI 1.4–3.3; depression: RR 1.5, 95 % CI 1.1–1.8; and suicide attempt: RR 1.8, 95 % CI 1.4–2.3. Similar results were observed for individuals with hypermobility syndrome and their siblings.ConclusionsIndividuals with EDS and hypermobility syndrome are at increased risks of being diagnosed with psychiatric disorders. These risk increases may have a genetic and/or early environmental background as suggested by evidence showing that siblings to patients have elevated risks of certain psychiatric disorders.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0922-6) contains supplementary material, which is available to authorized users.

Generalised joint hypermobility and neurodevelopmental traits in a non-clinical adult population

“…Genes coding for extracellular matrix could play a crucial part. The findings by Cederlöf et al, 24 an increased risk of psychiatric disorders not only in individuals diagnosed with EDS but also in their unaffected siblings, support a common genetic component. In most EDS subtypes a pathogenic basis, such as genes involved in collagen synthesis, has been identified, but for hEDS, the genetic aetiology remains unclear.…”

The evidence‐based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome

“…A systematic review has demonstrated that compared with their non‐affected peers, adults with JHS/hEDS have greater risk of anxiety, depression and panic disorders [Smith et al, ]. A nationwide population‐based cohort study showed a high incidence of psychiatric disorders including anxiety, depression, attention deficit hyperactivity disorder, and autism spectrum disorder in the JHS/hEDS patient population [Cederlöf et al, ].…”

Identification of a de novo case of COL5A1‐related Ehlers‐Danlos syndrome in an infant in the West Indies leading to improved targeted clinical care

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