Alexithymia and facial emotion recognition in patients with craniofacial pain and association of alexithymia with anxiety and depression: a systematic review with meta-analysis

Abstract

Background We aimed to determine the presence of alexithymia in patients with craniofacial pain (CFP) compared with asymptomatic individuals. Our secondary aims were to assess the relationship of alexithymia with anxiety and depression levels, as well as to assess the presence of facial emotion recognition deficit. Methods Medline, Scielo and Google Scholar were searched, with the last search performed in 8 September 2021. Standardized mean differences (SMDs) and 95% CIs were calculated for relevant outcomes and were pooled in a meta-analysis using the random effects model. In addition, meta-analyses of correlations and a meta-regression of alexithymia with depression and anxiety were performed. Results Regarding alexithymia, assessed through the Toronto Alexithymia Scale (TAS), the results showed significant differences, with higher values in patients compared with asymptomatic individuals, with a large clinical effect (SMD 0.46; 95% CI [0.22–0.71]; heterogeneity-Q 66.86; p < 0.001; inconsistency (I2) = 81%). We found statistically significant correlations with a small clinical effect of alexithymia with anxiety and depression. The meta-regression showed no significant association between the TAS and anxiety or depression. With respect to facial emotion recognition, the results showed statistically significant differences, with greater recognition difficulty in patients compared with asymptomatic individuals, with a large clinical effect (SMD −1.17; 95% CI [−2.01 to −0.33]; heterogeneity-Q 2.97; p = 0.080; I2 = 66%). Conclusions Patients with CFP showed alexithymia with moderate evidence. There was also moderate evidence indicating that these patients had significant deficits in facial emotion recognition compared with asymptomatic individuals. Furthermore, alexithymia showed statistically significant correlations with anxiety and depression levels.

Effects of comprehensive nursing intervention based on self-disclosure on improving alexithymia in elder patients with coronary heart disease

“…Alexithymia is defined as the disrupted emotional awareness, presents in a range of psychiatric and neurological disorders, and has a deleterious impact on functional outcomes and treatment response [5]. Alexithymia is a personality trait characterized by three dimensions: difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT) [6,7]. Alexithymia may also increase anxiety, depression, and stress, which can later become a predisposing factor to poor health and impaired quality of life along with inadequate social support [8].…”

Using exploratory graph analysis (EGA) in validating the structure of the Perth alexithymia questionnaire in Iranians with chronic pain

“…Patients grappling with CP encounter heightened difficulties in regulating emotion., These are often accompanied by associated physical ailments ( La Touche et al, 2021 ). Research indicates that elevated levels of alexithymia are linked to various adverse outcomes in individuals with CP, including somatization ( Lanzara et al, 2020 ), diminished quality of life ( Tesio et al, 2018 ), psychological distress ( Ghiggia et al, 2022 ), sexual dysfunction ( Aboussouan et al, 2021 ), eating disorders ( Fazia et al, 2024 ), increased pain intensity ( Aaron et al, 2019b ), pain catastrophizing ( Shim et al, 2018 ), anger ( Di Tella et al, 2018 ), and post-traumatic stress disorder ( Fang and Chung, 2023 ).…”

Occurrence of Alexithymia and Its Association with Sports Practice from a Sample of University Students: Results from a French Cross-Sectional Study

“…Numerous studies have evaluated anxiety and depressive disorders in the general population and have demonstrated a relationship with alexithymia [6][7][8][9][10][11]. Alexithymia refers to a deficit in the ability to recognize and express emotions, use of concrete speech and thoughts related to external events, and a paucity of notional thought processes [12].…”