Functional somatic syndromes and joint hypermobility: A systematic review and meta-analysis, 2021, Chen et al

[Dolphin]

https://www.sciencedirect.com/science/article/abs/pii/S0022399921002014

Journal of Psychosomatic Research
Available online 24 June 2021, 110556

Review article
Functional somatic syndromes and joint hypermobility: A systematic review and meta-analysis
Author links open overlay panelGrantChenaJames S.OlverabRichard A.Kanaanabcd
a
University of Melbourne, Department of Psychiatry, Austin Health, Heidelberg, VIC 3084, Australia
b
Fellow of the Royal Australian and New Zealand College of Psychiatrists, Australia
c
The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC 3084, Australia
d
King's College London, Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Denmark Hill, London SE5 9RJ, UK
Received 26 December 2020, Revised 17 June 2021, Accepted 18 June 2021, Available online 24 June 2021.

Highlights


• Joint hypermobility is associated with fibromyalgia and chronic fatigue syndrome.

• Joint hypermobility is associated with functional gastrointestinal disorder.

• Joint hypermobility could be a sign of functional somatic syndromes.

• Connective tissue pathology may be associated with functional somatic syndrome.


Abstract
Objective
There have been multiple reports of increased joint hypermobility (JH) in functional somatic syndromes (FSS). We sought to evaluate the evidence for an association.

Methods
A systematic search of the databases Medline and PsycINFO was conducted to identify all controlled studies from inception to February 2020 measuring the association of an FSS and JH. Records were identified and screened, and full-text articles assessed for eligibility by two independent authors. Meta-analysis was performed using random-effects modelling with the DerSimonian and Laird method.

Results
We found 220 studies initially, which yielded 11 studies for inclusion in the qualitative review and 10 in the quantitative analysis - 5 studies on fibromyalgia, 3 on chronic fatigue syndrome and 3 on functional gastrointestinal disorder. Nine of the 11 studies found increased rates of JH in FSS compared to controls, though most studies were fair to poor in quality. Meta-analysis showed a weighted summary effect odds ratio of 3.27 (95% CI: 1.83, 5.84; p < 0.001) of JH in FSS, suggesting greater odds of FSS in individuals with JH than in those without.

Conclusions
There is some evidence for an association between FSS and JH, but this is limited by the generally poor quality of studies and the narrow range of FSS studied. Better research is needed to confirm these findings as well as evaluate causation using prospective cohort studies.

Keywords
Joint hypermobility
Joint laxity
Functional somatic syndrome
Fibromyalgia
Chronic fatigue syndrome
Functional gastrointestinal disorder
Acronyms
JH
joint hypermobility
FSS
functional somatic syndrome

 

[Mithriel]

Something causes joint hypermobility and that same something probably affects other functions of the body too. Lax ligaments will cause foot pain for instance.

The gut being affected doesn't seem strange but are there more seizures? FSS covers so many things it is useful for information.

It looks much more as if joint hypermobility has widespread effects in the body and these are being dismissed as FSS instead of researched.

How the psychological underpinnings of FSS could cause JH or why JH should cause psychological vulnerabilities looks much more mysterious.

 

[Sean]

Joint hypermobility could be a sign of functional somatic syndromes.

Connective tissue pathology may be associated with functional somatic syndrome.

Or the whole notion of functional somatic syndrome is just irrelevant acausal psycho-obfuscation retarding our attempt to understand what is actually happening here.

Or are they arguing that FSS causes hypermobility?

 

[Sean]

Snap!

 

[Jonathan Edwards]

I am afraid I am not motivated to look more closely than the abstract since it tells us nothing other than that for some reason BPS people also like to believe in joint hypermobility as the B bit.

From what I have read the evidence is against any association of joint hypermobility with anything much. Most studies use tertiary referrals which makes them nonsense. Some large population based studies seemed to show no association.

There is absolutely no reason why joint ligament laxity should be relevant to anything much except sprains and sometimes dislocations of shoulders and it is not difficult to distinguish sprains and dislocations from fibromyalgia, ME, FND or IBS.

If this was a study of any real value the abstract would give some hard data and the 'highlights' would not misrepresent the findings in the way they do.

And it would not be published in the Journal of Imaginary Research