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

Abstract

Background and Objective People with fibromyalgia (FM) often report having difficulty with emotional identification and expression, and this “alexithymia” may contribute to their pain and other symptoms. Multiple studies have assessed alexithymia in FM, and we systematically reviewed and meta‐analyzed this literature to: (a) describe the prevalence of alexithymia in people with FM; (b) compare the level of alexithymia in FM to both healthy controls and controls with other pain conditions; and (c) determine the association of alexithymia to pain intensity, depression, and anxiety in people with FM. Databases and Data Treatment Following PRISMA guidelines, we searched multiple databases (Scopus, PubMed/MEDLINE, Embase, Web of Science, PsycINFO and Google Scholar) from inception to May 31, 2022. Study quality was assessed with The Joanna Briggs Institute (JBI) tools for cross‐sectional studies, and STATA:17 was used for meta‐analysis. A total of 32 studies met eligibility criteria and were included in meta‐analyses. Results The prevalence of alexithymia in FM averaged 48%. People with FM had substantially higher alexithymia than healthy controls (SMD = 1.00; 95% CI: 0.79 to 1.22), as well people with other pain‐related conditions (SMD = 0.35, 95% CI = 0.04 to 0.65), particularly rheumatoid arthritis (SMD = 0.49; 95% CI: 0.08–0.91). Alexithymia was positively associated with pain intensity (r = 0.24), anxiety (r = 0.50), and depression (r = 0.41) among people with FM. Conclusions Due to the high level of alexithymia in people with FM and the positive relationship of alexithymia with pain and psychological distress, interventions to improve emotional awareness, expression, and processing in FM are recommended.

Effects of Prolonged Medical Fasting during an Inpatient, Multimodal, Nature-Based Treatment on Pain, Physical Function, and Psychometric Parameters in Patients with Fibromyalgia: An Observational Study

“…Depression has been linked to poorer outcomes in FMS patients [7] and alexithymia has been positively associated with pain [8]. This is why interventions enhancing mindful awareness have been proposed to be integrated in therapeutic concepts in FMS [8]. In our study, we could see a rise in mindfulness, measured by the MAAS questionnaire, at V1 compared to baseline.…”

“…Four in ten FMS patients are reported to show depressive symptomatology [7]. Depression has been linked to poorer outcomes in FMS patients [7] and alexithymia has been positively associated with pain [8]. This is why interventions enhancing mindful awareness have been proposed to be integrated in therapeutic concepts in FMS [8].…”

“…Further associations have been found with biosocial stressors and trauma, especially physical abuse history [6]. FMS is often accompanied by psychological symptomatology, including depression [7] and alexithymia [8].…”

Authors' reply to the comment ‘The importance of measurement content and study design’ by Veirman et al. (2023)

“…Authors' reply to the comment 'The importance of measurement content and study design' by Veirman et al (2023) We read with interest the issues raised by Veirman et al (2023) about our article, 'The Relationship of Alexithymia to Pain and Other Symptoms in Fibromyalgia: A Systematic Review and Meta-analysis' (Habibi Asgarabad et al, 2023). Here, we reflect on some of the points they raised-agreeing with some and challenging others.…”

Aquatic Exercise in Physical Therapy Treatment for Fibromyalgia: Systematic Review

“…It is a syndrome that affects between 0.2% and 6.6% of the global population, particularly women over the age of 50 [ 2 , 3 ]. The pathophysiology of this disorder is not clearly defined [ 2 , 4 ], which complicates diagnosis and treatment, although its origin could be related to a combination of genetic, biological, psychological, and environmental factors [ 5 , 6 , 7 , 8 ].…”