Alexitimia e fibromialgia: uma revisão sistemática

Abstract

Fibromyalgia is a chronic musculoskeletal pain syndrome characterized by the presence of painful points on digito-palpation in anatomical specific areas, called trigger points, followed by psychological disorders like sleeping problems and alexithymia. Alexithymia is a dimension defined as the absence of words for emotions. The patient does not know how to process their own emotions and fail to externalize what feels. The investigation of possible relationship between Fibromyalgia and Alexithymia can increase knowledge about the clinical features resulting from both diseases, especially because alexithymia is poorly explored and has a significant impact in patient’s life quality. Objectives: To execute a literature review searching for a clinical association between Alexithymia and Fibromyalgia (FM), highlighting psychiatric and psychological aspects. Methods: Folowing PRISMA statement the research used Scielo, Pubmed, PsychLit and ISIweb of knowledge data base between 2009 and 2014 with the key-words: “alexithymia”, “fibromyalgia”, “psychosomatics”, “chronical pain”, “psycotherapy”, “psychoanalysis”. Results: Nine studies were selected for analysis which used instruments like the Toronto Alexithymia Scale, the psychoanalysis and cognitive comportamental therapy showing that the patient with Alexithymia and FM has a worse pain interpretation, deals badly with it and suffer the consequences in their physical and mental health due to that. Conclusion: This study suggested the important impact that alexithymia has in patients with FM, since the psychiatric and psychological factors lead to a bigger decrease in life quality of people who have already worse aspects in that, which warn for the importance of this emotional state, since it is under-diagnosed. Due to the fact that there were a small number of reviewed articles, more research about the relation between FM and Alexithymia must be done.

Machine Learning Increases Diagnosticity in Psychometric Evaluation of Alexithymia in Fibromyalgia

“…To date it is possible to affirm that there is no univocal relationship between the two aspects, but that alexithymia leads to an altered interpretation of some emotions and a worsening of the quality of life. Furthermore, a few factors such as pain perception, presence of anxiety, high level of catastrophization, and distress in patients with FMS, should bring the clinicians and health experts back to the importance of the patients' emotional health (10)(11)(12). Moreover, alexithymia seems to be associated with an increased affective pain and hypochondriacal illness behavior in FMS patients, with a mediating effect of psychological distress and illness behavior itself (13).…”

The relationship of alexithymia to pain and other symptoms in fibromyalgia: A systematic review and meta‐analysis

“…Although prior reviews of FM (Conversano et al, 2018;Di Tella & Castelli, 2013Romagnolli et al, have discussed the possible role of alexithymia, the current systematic review and set of meta-analyses were the first to directly examine and quantify these relationships. We found that alexithymia is very prevalent in FM; on average, 48% of those with FM have elevated alexithymia, and the mean TAS-20 total score was over 55.…”

“…That review, however, examined a heterogeneous set of chronic pain studies; it did not report specifically on FM nor include some studies on FM, including recent ones. Although a few articles report systematic reviews of the literature on alexithymia and FM, each of them covered only a handful of studies, and none conducted meta‐analyses (Conversano et al, 2018; Di Tella & Castelli, 2013; Romagnolli et al, 2016). Thus, a comprehensive systematic review and meta‐analyses are needed to address important yet unanswered questions.…”