Fletcher Elizabeth Kathleen Stockton, Fischer Ashley Loren, Manocha Ranita Harpreet Kaur
Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Rheumatol Int. 2025 Apr 28;45(5):128. doi: 10.1007/s00296-025-05869-5.
Individuals living with Hypermobility Spectrum Disorders and the hypermobile Ehlers-Danlos syndrome (HSD/hEDS) often experience recurrent joint injury, chronic pain, and fatigue. Although generalized anxiety has been recognized as a common comorbidity with HSD/hEDS, minimal research has examined depressive symptoms in this population. The purpose of this investigation was to describe the prevalence, nature, and severity of depressive symptoms in the HSD/hEDS population, and to explore associations with other potential confounding factors. All individuals with HSD/hEDS referred to a specialized connective tissue disorder Physical Medicine & Rehabilitation clinic were asked to self-report demographic data and complete the 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), Pain Catastrophizing Symptoms (PCS) questionnaire, and Fatigue Severity Scale (FSS) at their initial clinic visit. Data was prospectively collected between January 2019 and December 2024. Descriptive statistics were performed. A Spearman correlation matrix was used to identify relevant factors associated with depressive symptoms. Relationships emerging as significant (p < 0.001) were further analyzed using independent sample Mann-Whitney U-tests. Fifty-nine individuals (53 female, mean ± SD age: 34.4 ± 11 years) were included, with a mean ± SD PHQ-9 score of 11.2 ± 5.9, indicating moderate depressive symptom severity. 53% of participants (n = 31) met criteria for major depressive disorder (PHQ-9 ≥ 10). Higher pain catastrophizing (ρ = 0.611, p < 0.001) and higher fatigue scores (ρ = 0.593, p < 0.001) were both associated with significantly higher depressive symptoms, but there were no associations with respect to age, working status, and number of alcoholic drinks consumed per week. This research suggests that depression is highly prevalent in patients experiencing HSD/hEDS. There is also a strong association between pain catastrophizing and fatigue in those experiencing depressive symptoms. The interaction between depressive symptoms, pain catastrophizing, and fatigue should be considered in the holistic management of HSD/hEDS.
患有高活动度谱系障碍和高活动型埃勒斯-当洛综合征（HSD/hEDS）的个体经常经历反复的关节损伤、慢性疼痛和疲劳。尽管广泛性焦虑已被确认为HSD/hEDS的常见共病，但针对该人群抑郁症状的研究却很少。本研究的目的是描述HSD/hEDS人群中抑郁症状的患病率、性质和严重程度，并探讨其与其他潜在混杂因素的关联。所有转诊至专门的结缔组织疾病物理医学与康复诊所的HSD/hEDS患者均被要求在首次就诊时自行报告人口统计学数据，并完成9项患者健康问卷（PHQ-9）、7项广泛性焦虑障碍问卷（GAD-7）、疼痛灾难化症状（PCS）问卷和疲劳严重程度量表（FSS）。数据前瞻性收集于2019年1月至2024年12月之间。进行了描述性统计。使用Spearman相关矩阵来确定与抑郁症状相关的因素。对具有显著相关性（p < 0.001）的关系进一步使用独立样本Mann-Whitney U检验进行分析。纳入了59名个体（53名女性，平均±标准差年龄：34.4 ± 11岁），PHQ-9平均±标准差评分为11.2 ± 5.9，表明抑郁症状严重程度为中度。53%的参与者（n = 31）符合重度抑郁症的标准（PHQ-9 ≥ 10）。更高的疼痛灾难化程度（ρ = 0.611，p < 0.001）和更高的疲劳评分（ρ = 0.593，p < 0.001）均与显著更高的抑郁症状相关，但与年龄、工作状态和每周饮酒量无关。本研究表明，抑郁症在患有HSD/hEDS的患者中高度流行。在有抑郁症状的患者中，疼痛灾难化与疲劳之间也存在很强的关联。在HSD/hEDS的整体管理中应考虑抑郁症状、疼痛灾难化和疲劳之间的相互作用。
