Prevalence and correlates of alexithymia in older persons with medically (un)explained physical symptoms

Abstract

Objectives Much is unknown about the combination of Medically Unexplained Symptoms (MUS) and alexithymia in later life, but it may culminate in a high disease burden for older patients. In the present study we assess the prevalence of alexithymia in older patients with either MUS or Medically Explained Symptoms (MES) and we explore physical, psychological and social correlates of alexithymia. Methods and Design A case control study was performed. We recruited older persons (>60 years) with MUS (N = 118) or MES (N = 154) from the general public, general practitioner clinics and hospitals. Alexithymia was measured by the 20‐item Toronto Alexithymia Scale, correlates were measured by various questionnaires. Results Prevalence and severity of alexithymia were higher among older persons with MUS compared to MES. Alexithymia prevalence in the MUS subgroup was 23.7%. We found no association between alexithymia and increasing age. Alexithymia was associated with depressive symptoms, especially in the MUS population. Conclusions Alexithymia prevalence was lower than generally found in younger patients with somatoform disorder, but comparable to studies with similar diagnostic methods for MUS. Considering the high prevalence and presumed etiological impact of alexithymia in older patients with MUS, as well as its association with depression, this stresses the need to develop better understanding of the associations between alexithymia, MUS and depression in later life.

The relationship between alexithymia, depression, anxiety, and stress in elderly with multiple chronic conditions in China: a network analysis

“…For instance, many people are often unaware of the activities happening within them and do not know if their existing feelings are sadness or anger. Previous total score-based studies (14,45) have found that DIF scores were highest in chronically ill older adults with alexithymia, further reinforcing its central role. Core nodes can spread their effects to peripheral nodes and thus be the main targets of psychological interventions (26).…”

“…Older adults with MCC often experience varying degrees of dysfunction due to physiological degeneration and declining resilience within their bodies ( 57 ). Individuals with lower psychological resilience may develop feelings of hopelessness and helplessness ( 12 , 47 ), which, when combined with the breakdown of their psychological defenses, can lead to a lack of life expectations and the emergence of symptoms such as depression and frustration. This pattern was further supported by a recent study involving older adults ( 53 ).…”

“…Moreover, limited research has examined the impact of alexithymia on psychological distress in older adults ( 9 , 10 ), especially those with MCC. Nevertheless, it is evident that older adults with MCC are more susceptible to these emotional issues ( 11 , 12 ).…”

“…Alexithymia, initially described by Sifneos ( 13 ), is a cognitive-affective disorder characterized by difficulties in processing, regulating, and recognizing emotions. It is prevalent among elderly patients with chronic diseases ( 14 , 15 ), with a global prevalence ranging from 10 to 60% ( 16 ). Elderly patients with MCC have a higher prevalence of alexithymia compared to those with a single chronic condition, and the prevalence increases with age ( 17 ).…”

Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of the elderly in nursing homes: a quasi-experimental study

“…Several systematic reviews [3,4] have reported the prevalence of alexithymia to be approximately 10-23% in the general population and 18-50% in psychiatric population. Several lines of evidence have shown that the alexithymia is positively correlated with increasing age, with fewer younger (4.7-27.3%) than older people (13.9-29.3%) [5][6][7][8]. The prevalence of alexithymia appears to be higher in China than in other countries [9].…”