Value of joint hypermobility assessment as a clinical marker in psychiatric emergency care

Introduction Anxiety disorders are among the most frequent reasons for psychiatric emergency consultations, yet their identification remains challenging. Joint hypermobility syndrome has consistently been associated with anxiety in both clinical and community samples, but its usefulness in psychiatric emergency settings has not been investigated. Aim To investigate whether joint hypermobility is associated with anxiety in psychiatric emergency care, to examine its relationship with illness severity and global functioning, and to evaluate its predictive value for an anxiety diagnosis at discharge. Material and methods This prospective study included 400 consecutive patients attending the psychiatric emergency department of a general hospital. Participants were assessed using the Severity of Psychiatric Illness (SPI) scale, the Anxiety Screening Questionnaire (ASQ-15), the Global Assessment of Functioning (GAF) scale, and a validated self-administered questionnaire developed by Hakim and Grahame for joint hypermobility. Associations between joint hypermobility and anxiety diagnoses were examined using bivariate analyses (ANOVA and chi-squared test) and multivariable logistic regression. Results At discharge, 61.2% of patients diagnosed with an anxiety disorder met criteria for joint hypermobility (score ≥3), compared with only 17.4% of patients with other diagnoses (χ² = 39.34, p < 0.0001). In the multivariable logistic regression model, joint hypermobility was independently associated with an anxiety diagnosis at discharge (OR = 4.70, 95% CI 2.31–9.56), together with lower psychiatric illness severity, and younger age. The final model showed good discriminative ability (AUC = 0.863). Joint hypermobility screening demonstrated a sensitivity of 68.1% and a specificity of 80.6% for anxiety disorders at discharge. Conclusion Joint hypermobility is associated with anxiety disorders in psychiatric emergency care and may provide a simple, low-cost clinical marker to support the identification of anxiety disorders in this setting. Further studies are warranted to confirm its diagnostic utility and generalizability.