Baeza-Velasco Carolina, Sinibaldi Lorenzo, Castori Marco
Laboratory of Psychopathology and Health Processes, University Paris Descartes - Sorbonne Paris Cité, Boulogne Billancourt, France.
INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.
Atten Defic Hyperact Disord. 2018 Sep;10(3):163-175. doi: 10.1007/s12402-018-0252-2. Epub 2018 Feb 14.
Attention-deficit/hyperactivity disorder (ADHD) and generalized joint hypermobility (JH) are two separated conditions, assessed, and managed by different specialists without overlapping interests. Recently, some researchers highlighted an unexpected association between these two clinical entities. This happens in a scenario of increasing awareness on the protean detrimental effects that congenital anomalies of the connective tissue may have on human health and development. To review pertinent literature to identify possible connections between ADHD and GJH, special emphasis was put on musculoskeletal pain and syndromic presentations of GJH, particularly the hypermobile Ehlers-Danlos syndrome. A comprehensive search of scientific databases and references lists was conducted, encompassing publications based on qualitative and quantitative research. Impaired coordination and proprioception, fatigue, chronic pain, and dysautonomia are identified as potential bridges between ADHD and JH. Based on these findings, a map of the pathophysiological and psychopathological pathways connecting both conditions is proposed. Although ADHD and JH are traditionally separated human attributes, their association may testify for the dyadic nature of mind-body connections during critical periods of post-natal development. Such a mixed picture has potentially important consequences in terms of disability and deserves more clinical and research attention.
注意力缺陷多动障碍(ADHD)和全身关节活动过度(JH)是两种不同的病症,由不同的专科医生进行评估和管理,他们的关注领域并不重叠。最近,一些研究人员强调了这两种临床病症之间出人意料的关联。这种情况发生在人们越来越意识到结缔组织先天性异常可能对人类健康和发育产生的多种有害影响的背景下。为了回顾相关文献以确定ADHD和GJH之间可能存在的联系,特别关注了GJH的肌肉骨骼疼痛和综合征表现,尤其是活动过度型埃勒斯-当洛综合征。对科学数据库和参考文献列表进行了全面搜索,涵盖基于定性和定量研究的出版物。协调和本体感觉受损、疲劳、慢性疼痛和自主神经功能障碍被确定为ADHD和JH之间的潜在联系桥梁。基于这些发现,提出了连接这两种病症的病理生理和精神病理途径图。尽管ADHD和JH传统上是不同的人类特征,但它们之间的关联可能证明了产后发育关键时期身心联系的二元性。这种复杂的情况在残疾方面可能产生重要后果,值得更多的临床和研究关注。