Alexithymia as a prognostic risk factor for health problems: a brief review of epidemiological studies

Abstract

The number of articles on alexithymia has been steadily increasing since the word “alexithymia” was coined in the 1970s to denote a common characteristic that is observed among classic psychosomatic patients in whom therapy was unsuccessful. Alexithymia, a disorder of affect regulation, has been suggested to be broadly associated with various mental and physical health problems. However, most available evidence is based on anecdotal reports or cross-sectional observations. To clarify the predictive value of alexithymia for health problems, a systematic review of prospective studies was conducted. A search of the PubMed database identified 1,507 articles on “alexithymia” that were published by July 31, 2011. Among them, only 7 studies examined the developmental risks of alexithymia for health problems among nonclinical populations and 38 studies examined the prognostic value of alexithymia among clinical populations. Approximately half of the studies reported statistically significant adverse effects, while 5 studies demonstrated favorable effects of alexithymia on health outcomes; four of them were associated with surgical interventions and two involved cancer patients. The studies that showed insignificant results tended to have a small sample size. In conclusion, epidemiological evidence regarding alexithymia as a prognostic risk factor for health problems remains un-established. Even though alexithymia is considered to be an unfavorable characteristic for disease control and health promotion overall, some beneficial aspects are suggested. More prospective studies with sufficient sample sizes and follow-up period, especially those involving life course analyses, are needed to confirm the contribution of alexithymia to health problems.

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

“…Future studies should confirm the interaction between emotional distress and the strength of internal or external stimuli on symptom perception in patients with alexithymia. The findings of such a study may partly explain unhealthy behaviors, including the delay in health care utilization, low compliance, or other behaviors that can lead to poor health outcomes, including early death, that have been consistently observed in the population with alexithymia (11).…”

Factorial structure of the 20-item Toronto Alexithymia Scale in a large sample of somatoform patients

“…With regard to the subscales of the TAS-20 as described originally by Bagby et al (1994a) particularly the scale "difficulty identifying feelings" showed strong associations with a wide range of psychopathological symptoms (Grabe et al, 2004). Kojima (2012) reviews relevant studies on alexithymia as a prognostic factor for health problems. Especially in patients with somatoform disorder the difficulty to identify feelings as described by the first TAS-20 subscale is seen as a relevant etiological factor (de Gucht and Heiser, 2003;Mattila et al, 2008).…”

Relationship between alexithymia and dependent personality disorder: A dimensional analysis

“…Alexithymia is associated with depression, anxiety and addiction notably substance and alcohol abuse and has also been implicated in the pathogenesis of physical illness notably psychosomatic disease (Hintikka et al, 2001;De Rick and Vanheule, 2007;Kojima, 2012). From a conceptual point of view, alexithymia can be considered either as a state or a trait.…”