A differentiated approach to the diagnosis and treatment of mental disorders in a patient with Ehlers-Danlos syndrome (clinical observation)

   Somatic and neurological hereditary disorders, which arise as a result of various genetic mutations and usually manifest from childhood, are often accompanied by various mental health disorders. These may include mental disorders of exogenous-organic origin, personality disorders that are exacerbated or develop against a background of prolonged, severe, disabling illness with reactions of decompensation and maladjustment; endogenous disorders may also occur comorbidity. Mental disorders in themselves complicate the clinical picture, reduce quality of life and exacerbate social maladjustment. Furthermore, mental disorders, particularly those of an anxiety-depressive nature, can aggravate somatic pathology via a psychosomatic mechanism, a factor that must be taken into account when providing care for such patients. To illustrate the above, we present a clinical case of a patient with Ehlers–Danlos syndrome (a hereditary connective tissue dysplasia), which manifests, in addition to musculoskeletal pathology, as pronounced cardiovascular, neurological and mental disorders. The latter are represented by an organic personality disorder of a predominantly hysterical nature with anxiety-depressive maladaptive reactions. The difficulties of differential diagnosis of personality disorders and therapeutic aspects are discussed.

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