Alexithymia and fibromyalgia: clinical evidence

Abstract

This review proposes a critical discussion of the latest studies investigating the presence of alexithymia in patients with fibromyalgia (FM) and its relation to other psychological disorders. The focus is on the most relevant literature exploring the relationship between FM, a chronic pain syndrome, and alexithymia, an affective dysregulation, largely observed in psychosomatic diseases. The articles were selected from the Medline/Pubmed database using the search terms “Fibromyalgia,” “Alexithymia,” and “Psychological Distress.” Of the seven studies fulfilling these criteria, one found no differences between FM patients and the control group, four found significant differences, with higher levels of alexithymia in the FM sample, while two showed unclear results. Overall, the majority of findings highlighted the high prevalence of alexithymia in FM patients. Future studies should clarify the role of alexithymia in FM, paying attention to two principal aspects: the use, as a control group, of patients with chronic pain conditions but a low psychosomatic component, and the use of other measures, in addition to the Toronto Alexithymia Scale (TAS-20), to assess alexithymia.

Evidence of Contrasting Patterns for Suppression and Reappraisal Emotion Regulation Strategies in Alexithymia

“…While facing these inconveniencies, people may become emotionally more constricted. Indeed, pain is also often associated with different kinds of pain disorders, such as fibromyalgia, which furthermore is mainly or often associated with alexithymia (Di Tella and Castelli, 2013). Finally, another possible explanation is that elderly people have grown up in a different cultural environment and may have been brought up with different ways of dealing with their affects as compared with younger generations.…”

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

“…Aside from psychological distress, a broad association between alexithymia and various chronic health problems has been suggested (Di Tella & Castelli, 2013;Kilic, Sar, Taycan et al, 2014;Sayar, Gulec & Topbas, 2004;Tesio, Di Tella, Ghiggia et al, 2018), but few studies have investigate the role of alexithymia in pain perception as well as depression in patients with RA (Donisan et al, 2017;Karahan, Kucuk, Balkarli et al, 2016;Kojima, Kojima, Suzuki et al, 2014). The prevalence of alexithymia among individuals with RA is around 22-31% (Karahan et al, 2016;Kojima et al, 2014), but is not clear if this trait can be considered as a strong predictor of health-related quality of life (HRQoL) (Donisan et al, 2017;Kojima et al, 2014).…”

Alexithymia in Chronic Pain Disorders

“…In contrast to acute pain, which arises suddenly in response to a specific injury and is usually treatable, CP persists over time and is often resistant to medical treatments. As far as the psychological features of patients with CP conditions are concerned, alexithymia seems to play a key role [1][2][3]. Alexithymia is an emotional dysregulation, characterized by difficulties in identifying and describing subjective feelings, and by externally oriented thinking [4].…”

“…Chronic clinical pain conditions are generally labeled by: (1) the site of injury (e.g., back, head, viscera); and (2) type of injury (e.g., neuropathic, arthritic, cancer, myofascial, diabetic). Clinical manifestations are often a combination of several pain conditions; even in a specific condition, many different tissue types can be involved [9].…”