Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca. Spain.
Service de Médecine Physique, Centre Hospitalier Wallonie Picarde (CHWAPI), Tournai, Belgium.
Respir Med Res. 2023 Jun;83:101017. doi: 10.1016/j.resmer.2023.101017. Epub 2023 May 18.
Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most common type of EDS. Apart from joint symptoms, people with hEDS have systemic manifestations as a chronic modification of the breathing pattern (functional respiratory complaints (FRCs)) and mental disorders. However, the prevalence of FRCs, and its relationship with mental disorders, have not yet been estimated for this population.
To assess the FRCs, central sensitization, disease perception, depression, and anxiety in people with hEDS from Belgium; and to identify the clustering of FRCs and determine any association with the characteristics assessed for this sample.
This cross-sectional study assessed socio-demographic characteristics, Nijmegen questionnaire (NQ), Central Sensitization Inventory (CSI), Brief Illness Perception Questionnaire, and the Hospital Anxiety and Depression Scale (HADS) in people with hEDS from Belgium. A two-step cluster analysis was performed to identify clusters according to NQ, and to understand how the other questionnaires are grouped among these clusters.
The Spearman correlation coefficients showed that all the outcomes were significantly and positively correlated with each other (p<0.05). Furthermore, 84.9% of the sample had symptoms suggestive of FRCs, and 54.3% had probable anxiety. Three clusters were grouped (no FRCs, mild FRCs, and severe FRCs), with NQ, HADS-D and CSI-part A being the variables that contributed the most. People from cluster of severe FRCs got the worst scores for all the questionnaires.
FRCs, central sensitization, depression, and anxiety are prevalent comorbidities in people with hEDS. Moreover, those people with FRCs had worse results in the investigated parameters, with depression being the variable that contributed the most to the clusters of FRCs. Consequently, investigating mechanisms for these co-occurring symptom profiles may improve our understanding of pathogenesis and indicate new management strategies to alleviate these symptoms and lead to the development of more effective care for persons with hEDS.
过度活跃型埃勒斯-当洛斯综合征（hEDS）是最常见的埃勒斯-当洛斯综合征类型。除了关节症状外，hEDS 患者还存在全身性表现，如呼吸模式的慢性改变（功能性呼吸投诉（FRCs））和精神障碍。然而，对于这一人群，尚未对 FRCs 的流行情况及其与精神障碍的关系进行评估。
评估来自比利时的 hEDS 患者的 FRCs、中枢敏化、疾病感知、抑郁和焦虑情况；并确定 FRCs 的聚类情况，并确定其与该样本评估特征的任何关联。
本横断面研究评估了来自比利时的 hEDS 患者的社会人口统计学特征、尼姆根问卷（NQ）、中枢敏化量表（CSI）、简要疾病感知问卷和医院焦虑和抑郁量表（HADS）。采用两步聚类分析根据 NQ 识别聚类，并了解其他问卷在这些聚类中的分组方式。
斯皮尔曼相关系数显示，所有结果均与彼此显著正相关（p<0.05）。此外，84.9%的样本存在提示 FRCs 的症状，54.3%有焦虑可能。根据 NQ、HADS-D 和 CSI 部分 A，将三个聚类分组（无 FRCs、轻度 FRCs 和重度 FRCs）。FRCs 严重聚类的患者在所有问卷中的得分最差。
FRCs、中枢敏化、抑郁和焦虑是 hEDS 患者常见的合并症。此外，那些存在 FRCs 的患者在研究参数中表现出更差的结果，其中抑郁是对 FRCs 聚类贡献最大的变量。因此，研究这些共病症状谱的机制可能有助于我们更好地了解发病机制，并提示新的管理策略来减轻这些症状，从而为 hEDS 患者制定更有效的护理方案。
