Abstract

Background

Hypermobile Ehlers–Danlos syndrome (hEDS) is the most frequent heritable disorder of the connective tissue. This is characterized by a generalized fragility of tissues leading to chronic pain, disability and high levels of psychological distress. Suicidal behaviors in those affected are not uncommon but they have not been well studied. We aimed to explore aspects of suicidality and related factors in a group of patients with hEDS.

Method

Thirty-five women with hEDS were included in this cross-sectional study. They were assessed with the Mini-International Neuropsychiatric Interview for Axis 1 DSM-IV mental disorders and suicidality. They also responded to self-questionnaires assessing health (pain, BMI, and diagnosis delay) and psychosocial variables (social support, physical functioning, coping strategies, personality disturbances, and resilience).

Results

Eleven patients (31.4%) had attempted suicide in the past. Fifteen patients (42.9%) had some degree of suicide risk at the time of evaluation, mainly mild risk (60%). Compared with patients without a history of suicide attempt, those who had attempted suicide were younger, scored higher on personality disturbances, especially on depressive, avoidant, antisocial, and borderline trait subscores, and had an increased prevalence of lifetime major depression, mania/hypomanic episodes, and anxiety disorders (p < .05). Binary logistic regression showed that personality disturbances and anxiety disorders increase the probability of belonging to the attempters group.

Conclusions

Consistent with previous reports, these data highlight the high frequency of suicidal behaviors in hEDS patients as well as the importance to explore psychopathology in those affected in order to identify vulnerable individuals and provide specific support.

• HIGHLIGHTS

• Attempted suicide in patients with hEDS is not uncommon.

• Age and the presence of psychopathology are associated with suicide attempt in hEDS patients.

• Personality disturbances and lifetime anxiety disorders predicted suicide attempted in this sample.

中文翻译：

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患有超活动性埃勒斯-丹洛斯综合征的女性的自杀行为

摘要

背景

Hypermobile Ehlers-Danlos 综合征 (hEDS) 是结缔组织最常见的遗传性疾病。其特点是组织普遍脆弱，导致慢性疼痛、残疾和高度心理困扰。受影响者的自杀行为并不少见，但尚未得到很好的研究。我们旨在探讨一组 hEDS 患者的自杀倾向和相关因素。

方法

这项横断面研究包括 35 名患有 hEDS 的女性。他们通过 Axis 1 DSM-IV 精神障碍和自杀的小型国际神经精神病学访谈进行了评估。他们还回答了评估健康（疼痛、BMI 和诊断延迟）和社会心理变量（社会支持、身体机能、应对策略、人格障碍和复原力）的自我问卷调查。

结果

过去有 11 名患者 (31.4%) 曾企图自杀。15 名患者 (42.9%) 在评估时有一定程度的自杀风险，主要是轻度风险 (60%)。与没有自杀未遂史的患者相比，曾尝试自杀的患者更年轻，在人格障碍方面得分更高，尤其是在抑郁、回避、反社会和边缘特质子评分上，并且终生重度抑郁症、躁狂症/轻躁狂症的患病率增加发作和焦虑症 ( p < .05)。二元逻辑回归表明，人格障碍和焦虑症增加了属于尝试者群体的概率。

结论

与之前的报告一致，这些数据强调了 hEDS 患者自杀行为的高频率以及探索受影响者的精神病理学以识别易受伤害的个体并提供具体支持的重要性。

• 强调

• hEDS 患者自杀未遂的情况并不少见。

• 年龄和精神病理学的存在与 hEDS 患者的自杀企图有关。

• 在这个样本中，人格障碍和终生焦虑症预示着自杀未遂。