Ehlers-Danlos syndromes (EDS) are a heterogeneous group of hereditary connective 
tissue disorders characterized by joint hypermobility, widespread 
musculoskeletal pain and tissue fragility. Psychiatric disorders and 
psychosocial impairment are common, yet poorly characterized, findings in EDS 
patients. We investigated the frequency and types of psychiatric disorders and 
their relationship to systemic manifestations in a cohort of 106 classic and 
hypermobility type EDS patients. In this retrospective study, extensive medical 
chart review was performed for patients referred at two genetics clinics who 
were diagnosed with EDS. Statistical analysis was undertaken to determine the 
frequency of psychiatric disorders and association with systemic findings. 
Psychiatric disorders were found in 42.5% of the EDS cohort, with 22.7% of 
patients affected with 2 or more psychiatric diagnoses. Anxiety and depression 
were most commonly reported, with frequencies of 23.6 and 25.5%, respectively. A 
variety of other psychiatric diagnoses were also identified. Abdominal pain 
[odds ratio (OR) 7.38], neuropathic pain (OR 4.07), migraines (OR 5.21), joint 
pain (OR 2.85) and fatigue (OR 5.55) were significantly associated with the 
presence of a psychiatric disorder. The presence of any pain symptom was 
significantly associated with having a psychiatric disorder (OR 9.68). Muscle 
pain (OR 2.79), abdominal pain (OR 5.78), neuropathic pain (OR 3.91), migraines 
(OR 2.63) and fatigue (OR 3.78) were significantly associated with having an 
anxiety or mood disorder. Joint hypermobility and the classic dermatological 
features of EDS showed no significant association with having a psychiatric 
disorder. Our findings demonstrate a high frequency of psychiatric disorders and 
an association with pain symptoms in EDS.