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“Connective tissue” between panic disorder and dysautonomia

      We were very interested in the paper by Gazit et al (
      • Gazit Y.
      • Nahir A.M.
      • Grahame R.
      • Jacob G.
      Dysautonomia in the joint hypermobility syndrome.
      ) which concluded that patients suffering from joint hypermobility syndrome also suffer from dysautonomia. These results are similar to previously published psychiatric findings in patients with joint hypermobility syndrome (
      • Bulbena A.
      • Duró J.C.
      • Mateo A.
      • Porta-Serra M.
      • Vallejo J.
      Joint hypermobility syndrome and anxiety disorders.
      ). Panic disorder has been found to be almost seven times more likely among patients with joint hypermobility syndrome than among other rheumatologic outpatients (

      Bulbena A, Duró JC, Porta-Serra M, et al. Anxiety disorders in the joint hypermobility syndrome. Psychiatry Res. 1993;46:59-68

      ). Moreover, joint hypermobility has been found to be 16 times more probable in patients with panic disorder than in other age- and sex-controlled outpatients (
      • Martín-Santos R.
      • Bulbena A.
      • Porta-Serra M.
      • Gago J.
      • Molina L.
      • Duró J.C.
      Association between joint hypermobility syndrome and panic disorder.
      ). Both conditions have been related to a duplication of chromosome 15 (
      • Gratacós M.
      • Nadal M.
      • Martín-Santos R.
      • et al.
      A polymorphic genomic duplication on human chromosome 15 is a major susceptibility genetic factor for panic and phobic disorders.
      ). Mitral valve prolapse, a condition briefly commented on in Gazit et al's introduction, is a syndrome found both in joint hypermobility syndrome and in panic disorder and might also be related to dysautonomic symptoms.
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      References

        • Gazit Y.
        • Nahir A.M.
        • Grahame R.
        • Jacob G.
        Dysautonomia in the joint hypermobility syndrome.
        Am J Med. 2003; 115: 33-40
        • Bulbena A.
        • Duró J.C.
        • Mateo A.
        • Porta-Serra M.
        • Vallejo J.
        Joint hypermobility syndrome and anxiety disorders.
        Lancet. 1988; II: 694
      1. Bulbena A, Duró JC, Porta-Serra M, et al. Anxiety disorders in the joint hypermobility syndrome. Psychiatry Res. 1993;46:59-68

        • Martín-Santos R.
        • Bulbena A.
        • Porta-Serra M.
        • Gago J.
        • Molina L.
        • Duró J.C.
        Association between joint hypermobility syndrome and panic disorder.
        Am J Psychiatry. 1998; 155: 1578-1583
        • Gratacós M.
        • Nadal M.
        • Martín-Santos R.
        • et al.
        A polymorphic genomic duplication on human chromosome 15 is a major susceptibility genetic factor for panic and phobic disorders.
        Cell. 2001; 106: 367-379
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision (DSM-IV®-TR).
        American Psychiatric Press, Washington, D.C2000
        • Goodwin R.
        • Andersen R.M.
        Use of the behavioral model of health care use to identify correlates of use of treatment for panic attacks in the community.
        Soc Psychiatry Psychiatr Epidemiol. 2002; 37: 212
        • Katon W.J.
        • Von Korff M.
        • Lin E.
        Panic disorder.
        Am J Med. 1992; 92: 7S-11S
        • Pohl R.
        • Yeragani V.K.
        • Balon R.
        Effects of isoproterenol in panic disorder patients after antidepressant treatment.
        Biol Psychiatry. 1990; 28: 203-214
        • Collier D.
        FISH, flexible joints and panic.
        Br J Psychiatry. 2002; 181: 457-459

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