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Joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT) is a largely unrecognized, heritable connective tissue disorder, mainly characterized by joint instability complications, widespread musculoskeletal pain, and minor skin features. In a case-control study, 47 consecutive JHS/EDS-HT patients were investigated for the prevalence of psychiatric disorders and compared to 45 healthy controls in a single center. The psychiatric evaluation consisted of structured clinical interview for DSM-IV criteria by using the SCID-I and the SCID-II. Symptom severity was assessed using the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), and the Brief Psychiatric Rating Scale (BPRS). The Global Assessment of Functioning Scale (GAF) was used to assess the overall severity of psychological, social, and occupational functions. JHS/EDS-HT patients had significantly higher mean scores for all questionnaires: HAM-A (6.7 vs. 3.8), HAM-D (6.4 vs. 2.7), GAF (75.0 vs. 86.1), and BPRS (27.5 vs. 25.6). The JHS/EDS-HT group had a 4.3 higher risk of being affected by any psychiatric disorder, and in particular, a 5.8 higher risk of having a personality disorder. In particular, 5 JHS/EDS-HT suffered from obsessive-compulsive personality disorder with an observed prevalence rate of 10.6 % (3.6-23.1). Psychiatric assessment of JHS/EDS-HT patients showed an extremely high prevalence of personality disorders (21 %), and of Axis-I disorders (38 %), mostly depressive. This study did not confirm the previously reported increased rate of panic disorders in JHS/EDS-HT.

The aim of this study is to evaluate degree and possible major determinants of lower limb disability in joint hypermobility syndrome. Forty patients with joint hypermobility syndrome were studied. Lower limb function was evaluated with the lower limb functional scale (LEFS). Intensity of pain was estimated by the numeric rating scale. Rough results were compared with previously published data for osteoarthritis patients. Within the studied population, comparisons were performed by age, sex, numeric rating scale and Beighton scores. In joint hypermobility syndrome, LEFS score was similar to osteoarthritis, but in the former, comparable values were observed with a ~10 year earlier onset. LEFS scores resulted significantly related to age, pain intensity and Beighton score. No correlation with sex was observed. This study demonstrated that, in joint hypermobility syndrome, disability of lower limbs is remarkable and related to the increase in pain and age and to the decrease in residual joint hypermobility. These preliminary results may be relevant for the identification of more efficient and tailored treatment programs.