Depressive symptoms are highly prevalent and associated with fatigue and pain catastrophizing in [HSD/hEDS]: a cross-sectional study, 2025, Fletcher+

Depressive symptoms are highly prevalent and associated with fatigue and pain catastrophizing in the Hypermobility Spectrum Disorders and hypermobile Ehlers Danlos syndrome: a cross-sectional study

Elizabeth Kathleen Stockton Fletcher, Ashley Loren Fischer, Ranita Harpreet Kaur Manocha

[Line breaks added]

Abstract
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.

Link (Rheumatology International) [Paywall]

 

These threads appears to be relevant:
https://www.s4me.info/threads/catas...onstruct’-realities-2025-oter-quintana.43893/

https://www.s4me.info/threads/catastrophizing-time-to-ditch-the-term-me-cfs-skeptic-blog.40080/

 

I would be depressed if someone diagnosed me with hEDS and sent me to a rehab centre where they did mindless research.

Moreover, it would be a real catastrophe so it couldn't be further catastrophised.

 

sarcasm on

So, people in pain aren't really in pain, they are catasrophising??? But of course, "joint injury" isn't painful.

sarcasm off

I think telling someone (or insinuating) they are catastrophising when they are in pain just lets patients know they are not believed, are unlikely to be treated for their pain, and are unlikely to get better. No wonder people in this situation get depressed. And, although I've never suffered from the condition they are investigating in this paper, I know that being in pain is very, very fatiguing.

Why do researchers

a) so readily blame the patient

b) not understand that being in pain, particularly when untreated or under-treated, is exhausting.

c) turn cause and effect on its head, just so they can write a paper about it to make patients' lives harder.

 

I love the idea of hitting back with grammar.