Attention-deficit/hyperactivity disorder, joint hypermobility-related disorders and pain: expanding body-mind connections to the developmental age

Atten Defic Hyperact Disord. 2018 Sep;10(3):163-175. doi: 10.1007/s12402-018-0252-2. Epub 2018 Feb 14.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) and generalized joint hypermobility (JH) are two separated conditions, assessed, and managed by different specialists without overlapping interests. Recently, some researchers highlighted an unexpected association between these two clinical entities. This happens in a scenario of increasing awareness on the protean detrimental effects that congenital anomalies of the connective tissue may have on human health and development. To review pertinent literature to identify possible connections between ADHD and GJH, special emphasis was put on musculoskeletal pain and syndromic presentations of GJH, particularly the hypermobile Ehlers-Danlos syndrome. A comprehensive search of scientific databases and references lists was conducted, encompassing publications based on qualitative and quantitative research. Impaired coordination and proprioception, fatigue, chronic pain, and dysautonomia are identified as potential bridges between ADHD and JH. Based on these findings, a map of the pathophysiological and psychopathological pathways connecting both conditions is proposed. Although ADHD and JH are traditionally separated human attributes, their association may testify for the dyadic nature of mind-body connections during critical periods of post-natal development. Such a mixed picture has potentially important consequences in terms of disability and deserves more clinical and research attention.

Keywords: Attention-deficit/hyperactivity disorder; Connective tissue; Developmental coordination disorder; Ehlers–Danlos syndrome; Fibromyalgia; Joint hypermobility; Pain.

Publication types

  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Humans
  • Joint Instability / complications
  • Joint Instability / physiopathology*
  • Pain / complications
  • Pain / physiopathology*
  • Psychophysiology*