Alexithymia and Depression Affect Quality of Life in Patients With Chronic Pain: A Study on 205 Patients With Fibromyalgia

Abstract

Pain in fibromyalgia (FM) is accompanied by a heterogeneous series of other symptoms, which strongly affect patients’ quality of life and interfere with social and work performance. The present study aimed to evaluate the effects of alexithymia on both the physical and the psychosocial components of the health-related quality of life (HRQoL) of FM patients, controlling for the concomitant effects of depression, anxiety, and pain. In particular, given the strong interconnection between depression and alexithymia, the relationship between alexithymia and HRQoL as mediated by depressive symptoms was further investigated. Data were collected on a consecutive sample of 205 female patients with a main diagnosis of FM. The results showed that about 26% of the patients showed the presence of alexithymia, as assessed by the Toronto Alexithymia Scale (TAS-20). Clinically relevant levels of depressive and anxiety symptoms were present in 61 and 60% of the patients, respectively. The results of the hierarchical multiple regression analyses showed that pain intensity (PI) and depressive symptoms explained the 45% of the variance of the physical component of HRQoL (p < 0.001). Regarding the mental component of HRQoL, depressive and anxiety symptoms, alexithymia, and PI significantly explained 61% of the variance (p < 0.001). The mediation analyses confirmed that alexithymia had a direct effect on the mental component of HRQoL and showed a statistically significant indirect effect on both the physical and the mental components, through the mediation of depressive symptoms. In conclusion, the results of the present study suggested the presence of both a direct and an indirect effect of alexithymia, in particular of the difficulty identifying feeling, on the HRQoL of patients with FM. Indeed, even though the concomitant presence of depressive symptoms is responsible of an indirect effect, alexithymia per se seems to directly contribute to worsen the impact that this chronic pain pathology has on the patients’ quality of life, especially regarding the psychosocial functioning.

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

“…It is well known that depression and pain catastrophizing are two crucial psychosocial factors that influence the course and experience of chronic pain (Edwards et al ., ; Miller‐Matero, Chipungu, Martinez, Eshelman & Eisenstein, ; Morgan, ). Moreover, in contrast to the findings of a previous study performed with RA patients (Kojima et al ., ), but in agreement with a study performed with CP patients (Tesio et al ., ), the present regression analyses showed that also alexithymia significantly contributed to the explanation of both the physical and mental components of HRQoL.…”

“…Aside from psychological distress, a broad association between alexithymia and various chronic health problems has been suggested (Di Tella & Castelli, 2013;Kilic, Sar, Taycan et al, 2014;Sayar, Gulec & Topbas, 2004;Tesio, Di Tella, Ghiggia et al, 2018), but few studies have investigate the role of alexithymia in pain perception as well as depression in patients with RA (Donisan et al, 2017;Karahan, Kucuk, Balkarli et al, 2016;Kojima, Kojima, Suzuki et al, 2014). The prevalence of alexithymia among individuals with RA is around 22-31% (Karahan et al, 2016;Kojima et al, 2014), but is not clear if this trait can be considered as a strong predictor of health-related quality of life (HRQoL) (Donisan et al, 2017;Kojima et al, 2014).…”

Üniversite Öğrencilerinde Ağrı, Aleksitimi, Emosyonel Durum ve Yaşam Kalitesinin Değerlendirilmesi

“…Duygularını tanıma ve açıklamada zorlanan kişilerin fiziksel ve psikolojik belirtileri daha da artmakta ve kısır döngü içinde aleksitimik özellikleri besleyebilmektedir. 4 Aleksitimi duyguları tanıma ve açıklamada zorluk, fiziksel ve duygusal durumları ayırt edememe, hayal kurmada yetersizlik olarak tanımlanmıştır. 5 Çalışmalarda aleksitimik iletişim biçiminin başlangıçta psikosomatik hastalıklara özgü olduğu belirtilmişse de, günümüzde yalnızca bu hastalıklarda değil sağlıklı bireylerde de görüldüğü vurgulanmaktadır.…”

“…5 Çalışmalarda aleksitimik iletişim biçiminin başlangıçta psikosomatik hastalıklara özgü olduğu belirtilmişse de, günümüzde yalnızca bu hastalıklarda değil sağlıklı bireylerde de görüldüğü vurgulanmaktadır. 4,[6][7][8][9][10][11] Aleksitiminin ortaya çıkmasında sosyokültürel, kalıtsal ve çevresel faktörlerin etkili olduğu belirtilmektedir. Sosyoekonomik gelir seviyesi düşük olanlarda, kadınlarda ve ilerleyen yaşlarda aleksitimi görülme sıklığı artmaktadır.…”

“…11 Bu nedenle kişilerin psikolojik ve fiziksel semptomları değerlendirilirken aleksitimik özelliklerinin etkisi de irdelenmelidir. 4,14 Aleksitimi ruhsal bozukluk gelişiminde, kötü fiziksel sağlığa ve düşük yaşam kalitesine sahip olmada, çeşitli tıbbi sorunlar bakımından da önemli bir risk etmenidir. Ağrı ve kas-iskelet sistemi problemlerinin altta yatan sebeplerinin erken izlemi yapılmazsa, bireylerde depresif belirti artışı, sosyal izolasyon ve düşük yaşam kalitesi gibi sorunlara ve bununla birlikte sosyoekonomik kayıplara yol açabileceği göz önüne alınmalıdır.…”