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We tested whether dysautonomia might mediate the association between hypermobility and anxiety in adults diagnosed with mental health disorders and\/or neurodevelopmental conditions (hereon referred to as patients), by quantifying joint hypermobility and symptoms of autonomic dysfunction. Prevalence of generalized joint laxity (hypermobility) in 377 individuals with diagnoses of mental health disorders and\/or neurodevelopmental conditions was compared to prevalence recorded in the general population. Autonomic symptom burden was compared between hypermobile and non\u2010hypermobile patients. Mediation analysis explored relationships between hypermobility, autonomic dysfunction, and anxiety. Patient participants had elevated prevalence of generalized joint laxity (38%) compared to the general population rate of 19% (odds ratio: 2.54 [95% confidence interval: 2.05, 3.16]). Hypermobile participants reported significantly more autonomic symptoms. Symptoms of orthostatic intolerance mediated the relationship between hypermobility and diagnosis of an anxiety disorder. Patients with mental health disorders and\/or neurodevelopmental conditions have high rates of joint hypermobility. Accompanying autonomic dysfunction mediates the association between joint hypermobility and clinical anxiety status. Increased recognition of this association can enhance mechanistic understanding and improve the management of multimorbidity expressed in physical symptoms and mental health difficulties.<\/jats:p>","DOI":"10.1002\/ajmg.c.31957","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T10:30:04Z","timestamp":1637577004000},"page":"500-509","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Variant connective tissue (joint hypermobility) and dysautonomia are associated with multimorbidity at the intersection between physical and psychological health"],"prefix":"10.1002","volume":"187","author":[{"given":"Jenny L. L.","family":"Csecs","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Brighton and Sussex Medical School University of Sussex  Falmer UK"},{"name":"Research and Development Sussex Partnership NHS Foundation Trust  Sussex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas G.","family":"Dowell","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Brighton and Sussex Medical School University of Sussex  Falmer UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia K.","family":"Savage","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Brighton and Sussex Medical School University of Sussex  Falmer UK"},{"name":"Research and Development Sussex Partnership NHS Foundation Trust  Sussex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Iodice","sequence":"additional","affiliation":[{"name":"Autonomic Unit National Hospital for Neurology and Neurosurgery  London UK"},{"name":"UCL Queen Square Institute of Neurology, Faculty of Brain Sciences University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Mathias","sequence":"additional","affiliation":[{"name":"Autonomic Unit National Hospital for Neurology and Neurosurgery  London UK"},{"name":"UCL Queen Square Institute of Neurology, Faculty of Brain Sciences University College London  London UK"},{"name":"Neurovascular Medicine (Pickering Unit) St Mary's Hospital, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo D.","family":"Critchley","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Brighton and Sussex Medical School University of Sussex  Falmer UK"},{"name":"Research and Development Sussex Partnership NHS Foundation Trust  Sussex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0062-1216","authenticated-orcid":false,"given":"Jessica A.","family":"Eccles","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Brighton and Sussex Medical School University of Sussex  Falmer UK"},{"name":"Research and Development Sussex Partnership NHS Foundation Trust  Sussex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12402-018-0252-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.32.5.413"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31544"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2011.03.004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/751768"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0922-6"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/9161865"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-018-4296-7"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30435"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2009.01.012"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"Csecs J. 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