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Alexithymia, by definition, involves difficulties in identifying and describing emotions and has been assumed to be associated with somatization (i.e., a tendency to express psychological distress in somatic rather than emotional form). Empirical research so far, however, has produced no convincing evidence that alexithymia is more associated with somatic complaints than with emotional complaints or that alexithymia correlates with somatic complaints when negative affect is controlled for. In the present study, alexithymia, as measured by the TAS-20, showed no association with somatic complaints in a community sample of 137 individuals when trait anxiety and depression were controlled. Alexithymia did correlate negatively with positive affect, and positively with negative affect. The former association, however, was much more robust, whereas the latter association was found mainly on subjective trait measures of negative affect (as distinct from state measures and more objective trait measures derived from daily recordings during an 8-week period). It is suggested that the association between alexithymia and lack of positive affect deserves more attention in future research.
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PMID:Alexithymia, emotion, and somatic complaints. 1147 34

A multidimensional appraisal of the patient suffering from chronic idiopatic constipation is used in this study. 16 consecutive patients affected by chronic idiopatic constipation defined by Rome criteria were enrolled. The following assessments were performed: radiological study of colorectal transit time using radiopaque markers, anorectal manometry, proctography, psychiatric appraisal, with the somministration of The Minnesota Multiphasic Personality Inventory 2, Hamilton Rating Scales for Depression, Hamilton Rating Scales for Anxiety, Toronto Alexithymia Scales, quality of life appraisal, by means of Short Form 36. The present study must be considered a pilot-study, lead on a limited champion of 16 cases; the reported data express therefore tendencies. Chronic idiopatic constipation appears to be a disturbance with a strong impact on the patient's quality of life. The study moreover confirms the hypothesis of a multifactorial genesis for chronic idiopatic constipation, in which psychopathological aspects (anxiety, depression and alessitimia in particular) and personality traits play a fundamental role, as much as the physiopathological alterations. Colorectal transit time study and anorectal manometry confirm to be valid instruments for the evaluation of physiopathological characteristics, useful for a classification of patients, particularly with respect to the presence of a normal or slowed colorectal transit and to the relief of pelvic floor dysfunctions. The differences between subgroups based on physiopathological characteristics, with respect to quality of the life and personality traits, expressed as tendency, need a confirm form studies lead on larger champions.
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PMID:[Multidimensional appraisal in patients suffering from chronic idiopathic constipation]. 1155 23

Alexithymia may be considered as a personality feature characterized by poorness of imaginary life, speech focused on actual facts and physical sensations, general inaccuracy in or paucity of the words used to express emotions, and recourse to acting out to avoid intrapsychic conflicts. The possible link between alexithymia and psychosomatic or psychopathological disorders is now well documented. In particular, studies suggested that alexithymia may be frequently observed in obese or bulimic patients. This study was designed to investigate the link between obesity and alexithymia according to the presence or not of binge eating problems; 40 obese female patients (BMI > or = 27.3) seeking obesity treatment and 32 normal weight women used as controls were included in the study. In the obese group, 11 patients (27.5%) exhibited binge-eating disorder according to the DSM IV criteria. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS), and past and current mental disorders were assessed by means of the Structured Clinical Interview for DSM III-R (SCID). In addition, current depression was assessed using the Beck Depression Inventory (BDI). The mean TAS score was found significantly higher in obese patients than in controls (72.6 +/- 11.8 vs 65.2 +/- 9.3, respectively; p < 0.005). In the same way, alexithymia (defined by TAS score > or = 74) was found significantly more frequent in obese patients than in controls (52.5% vs 21.8%, respectively; p < 0.03). However, among obese patients no significant difference was found between patients with and without binge-eating disorder. Current major depression was also found significantly more frequent in obese patients than in controls (15% vs 0%, respectively; p < 0.03), and the mean BDI score was very significantly higher in obese patients (12.2 +/- 8.7 vs 4.6 +/- 4.6, respectively; p < 0.0001). Comparisons between obese patients with and without binge-eating disorder showed that only past major depression was found significantly more frequent in those with binge-eating disorder (81.8% vs 10.3%, respectively; p < 0.0001), although the mean BDI score was significantly higher in patients with binge-eating disorder (18.5 +/- 11.7 vs 9.8 +/- 5.9, respectively; p < 0.02). Group by group comparisons suggested that two factors may play a role in the correlation found between obesity and alexithymia. First, the mean TAS score was found significantly higher in subjects with low educational level (p < 0.05), obese patients exhibiting significantly lower educational level when compared to controls (p < 0.002). Then, a significant positive correlation was found between TAS scores and BDI scores (Spearman's test: p < 0.01), obese patients showing significantly higher BDI scores than controls (p < 0.0001). In order to confirm these results, a logistic regression procedure was performed in the total sample (obese patients + controls). Three factors were found significantly increasing the risk to get a TAS score > or = 74: low educational level (odds ratio: 3.56), past and/or current major depression (odds ratio: 2.77), and BDI score > or = 8 (odds ratio: 2.18). Obesity in itself had no significant effect on TAS scores. Our results confirm that alexithymia is a psychological feature frequently observed in obese patients. In our study, the correlation found between obesity and alexithymia appears to be irrespective of binge-eating disorder, and seems to be mediated by the educational level and the frequency of associated depression. However, further investigations need to be done in order to specify the relationships between obesity, alexithymia, low educational level, and depression.
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PMID:[Obesity, alexithymia, psychopathology and binge eating: a comparative study of 40 obese patients and 32 controls]. 1168 56

To evaluate the prevalence of suicidal behavior in patients with panic disorder (PD) and to study the role of alexithymia (AL), an affect component, as a predictor of suicidal behavior in PD, we compared 42 patients with PD with or without agoraphobia with 24 healthy controls with regards to depression, AL and suicide risk. Only 5% of the PD patients reported previous suicide attempts. A higher frequency of positive AL (score > 73) was found among the PD patients (39% v 4% among the controls). PD patients had a higher suicide risk and AL as compared to controls, but only the increased suicide risk reached statistical significance. AL subjects had higher suicide risk scores as compared to non-AL subjects. Significant correlations were found between the AL score and suicide risk, although the most significant correlation was, as expected, between the depression level and the suicide risk. A low rate of previous suicide attempts was found in the PD group, perhaps reflecting the low comorbidity in our sample. We suggest that AL may have a role in the causation of suicidal behavior in PD patients, although further studies should re-examine this issue with larger samples.
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PMID:Alexithymia and suicidality in panic disorder. 1170 39

Alexithymia is a term denoting a deficit in the ability to differentiate emotional from physical states and to identify and describe one's feelings, as well as a preference for external oriented thinking. Alexithymia has been linked with various somatic and psychosomatic diseases, especially with chronic pain. The aim of this study was to evaluate the association between alexithymia and symptoms of temporomandibular disorders (TMD) as well as oro-lingual and dental pain, in a large representative population sample of young adults. The study was a part of the 31-year follow-up study of the Northern Finland Birth Cohort originally consisting of 12058 live births in the year 1966. In 1997, 4893 subjects living in northern Finland or in the capital area, who participated in a field study of the project and later returned a postal questionnaire, made up the sample of this study. Information concerning symptoms of TMD and oro-lingual and dental pain was collected from the subjects. To assess alexithymia, the Toronto Alexithymia Scale-20 (TAS-20) was used. In addition, information about depression, marital status and self-rated health was collected. The proportion of alexithymics (TAS score over 60) was higher in subjects with the most orofacial symptoms than in asymptomatic subjects. In men, alexithymia associated significantly with facial pain, difficulties in mouth opening, oro-lingual pain and dental pain, and in women with pain on jaw movement and dental pain. After adjusting for depression, marital status, and self-rated health, a significant association remained between alexithymia and the symptoms mentioned, except for facial pain in men. It can be concluded that alexithymia is connected with orofacial symptoms. Clinicians treating these symptoms should be familiar with the concept of alexithymia.
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PMID:Association of symptoms of TMD and orofacial pain with alexithymia: an epidemiological study of the Northern Finland 1966 Birth Cohort. 1172 48

Cognitive and psychiatric disorders have long been described in MS. However, these symptoms were only well evaluated starting about fifteen years ago. More recently, there has been renewed interest in cognitive and psychiatric assessment in MS, especially due to the emergence of new therapies for the disease. Psychiatric symptoms mainly include depression and anxiety. Depression is generally moderate, but there is a risk of suicide that is clearly higher than in the general population. Depression is not correlated with the duration of symptoms, type of disease or level of disability. Mild elation and pathological laughing and crying can be associated and are more frequent in case of severe disease. Bipolar affective disorders and alexithymia are more rare. The question of premorbid personality has been questioned for depression but not confirmed. It has been suspected for bipolar affective disorders. Cognitive disorders are observed in 40 to 65% of the cases at any period of the disease. They mainly include an impairment of working and long-term memory, executive functions and attention whereas global intellectual efficiency is impaired later. While cognitive disorders can be observed early in the course of the disease, there is no correlation with the level of disability or duration of the disease. Progressive MS and especially secondary progressive then primary progressive forms are more subject to cognitive deficits than relapsing remitting MS. For a similar cognitive impairment, progression could be a negative factor for the disease course. Cognitive and psychiatric assessment of patients can be discussed on the basis of why, how and when. Psychiatric assessment is not particularly difficult when there are psychiatric complaints, but cognitive assessment should be explained to the patients and justified when there is no complaint. However, detection of cognitive deficits would lead to better patient management. Psychiatric assessment will mainly use controlled or open interviews and assessment scales to evaluate the level of depression and/or anxiety. For cognitive assessment, short-term batteries focusing on the main dysfunctions are recommended. Psychometric evaluation should not be performed during a period of relapse, hospitalization or immediately after starting drug therapy for depression or anxiety. The cognitive evaluation should be explained to the patient and should include a parallel assessment by a psychologist well trained in MS. The evaluations will be adapted to the situation and the goals. Early interviews evaluate the psychopathological profile that can then be reevaluated during each consultation. Cognitive assessment is mainly proposed in case of interferon therapy, spontaneous complaints of the patient or abnormal difficulties in daily life or occupational activities. In all cases, patient management requires a multidisciplinary approach.
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PMID:[Neuropsychological evaluation and psychopathology of multiple sclerosis]. 1178 45

Alexithymia was investigated in a random population sample of 566 people over 60 years of age (average, 69.73 years; range, 61 to 95 years) with the help of a German version of the Toronto Alexithymia Scale (TAS-26), and the results were compared with those from a group of 1,481 people under 60 years of age (average, 38.86 years; range, 14 to 60 years). The average alexithymia values in the elderly were not significantly higher than those of the younger subjects under 60 years of age. A total of 15.2% of the elderly and 18% of the younger group registered more than 1 SD over the mean value of all those sampled. This difference is also not statistically significant. Levels of alexithymia were not associated with age, gender, or education in the over-60 groups. The alexithymia scales "difficulties with identifying feelings" and "difficulties with describing feelings" correlated significantly with negative mood and negative body experience. These results confirm the assumption that there is a connection between alexithymia and depression, and correspond to the findings of other studies, that alexithymia is associated with a tendency to psychosomatic illness.
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PMID:Alexithymia in the elderly general population. 1178 24

We conducted an interview-based survey to predict the clinical course of major depressive disorder during a follow-up period of 12 months. Altogether 86 patients were investigated. A SCID I interview for DSM-III-R axis-I diagnosis was conducted at baseline and a SCID II interview for personality disorders at the 6-month follow-up. Beck Depression Inventory scores indicated the level of depression and were compiled at baseline and at 6 and 12 months. A BDI score between 9 and 14 was considered to indicate partial remission, and score of 0-8 indicated remission. At the 6-month assessment 33% of the patients had remission, 20% were in partial remission, and 47% were in the depressive phase. Older age, personality disorder, and alexithymia were associated with poor response at 6 months. At 12 months 37% had remission, 28% were in partial remission, and 35% were still in the depressive phase. Treatment at the early stage should be effective enough to achieve remission. If the response is not satisfactory within 6 months, a renewed search should be conducted for factors hindering recovery. Comorbid personality disorder is the main factor predicting a poor short-term response in major depressive disorder.
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PMID:Partial remission in major depression: a two-phase, 12-month prospective study. 1186 63

To examine the relationship between somatosensory amplification and three factors of alexithymia (difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking), 48 outpatients attending a Japanese psychosomatic clinic and 33 comparative outpatients completed the Somatosensory Amplification Scale (SSAS), 20-item Toronto Alexithymia Scale (TAS-20), Profile of Mood States (POMS), and other self-rating questionnaires. The scores on the SSAS and the first and second TAS-20 factors were higher (all P<0.001) in the psychosomatic group than in the comparison group. The SSAS was positively associated (both P<0.01) with these two TAS-20 factors, controlling for the effects of age, sex, group, and POMS tension-anxiety and depression. Somatosensory amplification appears to be associated with difficulties identifying and describing feelings, not externally oriented thinking, in Japanese patients.
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PMID:Relationship between somatosensory amplification and alexithymia in a Japanese psychosomatic clinic. 1192 59

Random samples of 25 voluntary Finnish winter swimmers (7 males, 18 females) and 11 controls (3 males, 8 females were followed prospectively during the winter season from October 1999 to May 2000 to (determine whether winter swimming is beneficial for mental well-being, as many of its practitioners claim. The Crown-Crisp Experimental Index (CCEI) was used for measuring free-floating anxiety, phobic anxiety, obsessionality, depression, somatic anxiety and hysteria, and the 20-item version of the Toronto Alexithymia Scale (TAS-20) for measuring alexithymia. Self-reported somatic and mental health and the reasons for and the frequency of winter-swimming were asked, too. As resealed by open questions, the winter swimmers reported positive effects of winter swimming. Several of the swimmers also told that they had started winter swimming to improve their physical and mental health. Their experience was that the swimming had relieved physical symptoms and made their mood more positive. However, we found no major differences between winter swimmers and controls in any CCEI or TAS variables. The structured questionnaires do not necessarily, however, reach subjective feelings and experiences.
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PMID:Neurotic psychopathology and alexithymia among winter swimmers and controls--a prospective study. 1207 59


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