Impact of Alexithymia on Organ Transplant Candidates’ Quality of Life: The Mediating Role of Depressive Symptoms

Abstract

Solid organ transplant candidates who display alexithymia tend to report psychological distress with some displaying symptoms associated with depression which in turn has a negative impact on their quality of life. This study sought to examine the mediating role of depression on the relationship between alexithymia and physical and psychological quality of life. The sample comprised 707 patients who were under consideration for solid organ transplantation. Mediation models were used to examine the proposed hypotheses, specifically that alexithymia would predict quality of life, and that depression would mediate the relationship between alexithymia and physical and psychological quality of life. Findings revealed that alexithymia predicted both physical and psychological quality of life. Depression scores partially mediated the relationship between alexithymia and both physical and psychological quality of life. Transplant candidates with higher levels of alexithymia who report poor physical and psychological quality of life may be at increased risk for depression. Results highlight the need to assess alexithymia within this unique patient population, who may understate symptoms of depression due to attempts at positive impression management.

The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis

“…Our results are also consistent with the predisposition hypothesis, which posits that alexithymia is a stable personality trait (i.e., primary alexithymia) and is causally related to psychopathology [ 26 , 27 ]. As suggested by previous studies (e.g., [ 24 ]), patients with higher levels of alexithymia who report poor mental functioning may be at an increased risk of depression.…”

“…Many studies have shown positive correlations between alexithymia and measures of anxiety and depression (for a review, see [ 23 ]). Moreover, depression was found to partially mediate the relationship between alexithymia and both physical and mental functioning in patients with end-stage organ disease [ 24 ]. Individuals with alexithymia have deficits in the ability to link their emotional states to factors eliciting these emotions.…”

“…Moreover, the difficulty in identifying emotions affected somatization through distress and mental health impairment in patients with chronic pain, supporting the idea that alexithymia may increase somatic symptoms through emotional distress [ 33 ]. Finally, depression partially mediated the relationship between alexithymia scores and both physical and mental functioning in candidates for solid organ transplantation [ 24 ].…”

Depression in transplantation

“…Relevant for the mental health clinician are the psychological factors that increase the risk of depression in transplant candidates and recipients: guilt [45], feelings of punishments suicidal thoughts [46] and high perceived stress [47]. One study analyzed separately alexithymia and depressive symptoms in a group of mixed SOT patients and found that alexithymia was associated with lower scores on both psychological and physical quality of life, and that this association was mediated by depression [48]. Interestingly, coping strategies did not impact depression in lung transplant patients during coronavirus disease 2019 (COVID-19) pandemic [49].…”