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- Glans, Martin, 1985-, et al.
(författare)
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The Relationship Between Generalised Joint Hypermobility and Autism Spectrum Disorder in Adults : A Large, Cross-Sectional, Case Control Comparison
- 2022
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Autism spectrum disorder (ASD) and generalised joint hypermobility (GJH) share a number of clinical manifestations including proprioceptive impairment, motor difficulties, sensory hypersensitivity, and autonomic dysfunction. Clinical observations suggest that GJH is overrepresented in ASD. However, there are currently few systematic studies available. Knowledge about comorbidities may unfold common aetiopathological pathways underlying the association and improve the clinical management. The aim of this large, cross-sectional comparative study is to evaluate the relationship between ASD and GJH in adults. Data on joint hypermobility, symptoms associated with both hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS), lifetime psychiatric diagnoses, psychiatric rating scales for ASD and attention deficit hyperactivity disorder (ADHD), and socio-demographics was collected for 199 individuals with ASD and 419 non-ASD community controls. Logistic regression models adjusting for covariates (age, sex, ethnicity) revealed a significant relationship between ASD and GJH and between ASD and symptomatic GJH, with adjusted odds ratios of 3.1 (95% CI: 1.9, 5.2; p < 0.001) and 4.9 (95% CI: 2.6, 9.0; p < 0.001), respectively. However, the high prevalence of comorbid ADHD in the study sample reduces the generalizability of the results among individuals with ASD without comorbid ADHD. Possibly, an additional ADHD phenotype is the primary driver of the association between ASD and GJH. Furthermore, GJH with additional self-reported symptoms, suggestive of HSD/hEDS, showed a stronger association with ASD than did non-specified GJH, indicating that symptomatic GJH plays a greater role in the relationship than non-specified GJH does. Therefore, the current study underscores the need of careful sample subclassifications. ASD with GJH may represent a novel subgroup of ASD in terms of aetiopathology and clinical presentation. Future research should elucidate the aetiological factors behind the association between ASD and GJH and evaluate how the comorbidity of GJH affects ASD outcomes.
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| 2. |
- Glans, Martin, 1985-
(författare)
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The relationship between generalised joint hypermobility and neurodevelopment disorders
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Knowledge about comorbidities is important since they often can affect the diagnoses, treatment and outcome of a patient. Moreover, it may provide an insight to biological underpinnings contributing to the association. Generalised joint hypermobility (GJH) has recently been suggested to be a common, yet unrecognized, comorbidity amongst individuals with NDDs. In the present thesis we aimed to evaluate the relationships between GJH and ADHD and GJH and ASD across the full clinical and non-clinical spectra. Moreover, we aimed to make available a simple screening tool for GJH for Swedish speakers.In study I we translated the five-part questionnaire on hypermobility (5PQ) into Swedish and tested psychometric properties in a non-clinical adult population (n=315). The Swedish 5PQ showed good psychometric properties in the general adult population with a sensitivity of 91%, a specificity of 75%, and an AUC of 0.87. Thus, it is a promising measure for GJH screening in adults. In studies II and III we measured GJH in large cohorts of adults with ADHD (n=431), ASD (n=199) and general population controls (n=419). We evaluated the associations between GJH and ADHD and GJH and ASD by using logistic regression models, while adjusting for age, sex and ethnicity. GJH was associated with ADHD and ASD with adjusted odds ratios of 4.7 and 3.1, respectively.In study IV a large cohort of adults from the general population (n=887) completed a survey form comprising the 5PQ and questions regarding symptoms and traits of ADHD, ASD and motor impairment. Responses were compared between GJH and non-GJH individuals. We found that sub-syndromal neurodevelopmental symptoms were not affected by GJH. Thus, the association between GJH and NDDs appears to be limited to clinical populations. However, the hypothesis needs to be tested with a physical assessment of GJH before any firm conclusions can be drawn.
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