Alexithymia, Immunity and Cervical Intraepithelial Neoplasia: A Pilot Study

Abstract

Alexithymia and circulating lymphocyte subsets were studied in 62 women [36 healthy women and 26 women affected by cervical intraepithelial neoplasia (CIN I, II, III) who were not aware of their status] in order to assess a possible relationship between alexithymia, CIN and immunological lymphocytic functions. Alexithymia was estimated by the 20-item Schalling-Sifneos Personality Scale and then correlated with peripheral blood lymphocyte subsets. The results of our study report an association between alexithymia and CIN. Alexithymic women show lower rates of almost all lymphocytic subsets compared to nonalexithymic ones. The difference was also found between alexithymic women affected by CIN and alexithymic women with an unsuspicious Pap smear. On the whole, these preliminary results seem to confirm data reported by other authors who hypothesized that a certain personality trait characterized by emotional inhibiton is related to a greater cancer vulnerability. Such relationships might be mediated by certain lymphocytic functions as the result of the alexithymic status. Results reported here need more extensive surveys, in order to control potentially confounding factors related to the personality assessment of the subjects in this study.

Alexithymia in Cancer Patients: Review of the Literature

“…Eight studies provided information about staging, without including the stages in the analysis [23,24,25,26,33,35,36,37]; one specified that curative cases were included [34] and seven provided no information about the stages [19,22,27,32,38,39,40]. …”

“…In four studies alexithymia was assessed before cancer diagnosis, but no information was provided about the existence of other diseases or treatments [19,23,24,36]. Two studies specified whether patients were in palliative or curative treatment [33,35], one that alexithymia was assessed before surgery [38], one that patients underwent surgery and that analyses were controlled for adjuvant therapy [34], and four provided no information about treatment [22,32,39,40].…”

“…A statistically significant correlation has been found between alexithymia and certain lymphocyte clusters; the authors concluded that alexithymia seems to favor the development of cervical dysplasia through influence on the immune system [23,24]. …”

“…The hypothesis of the two different types of alexithymia, state and trait, has been supported by the different prevalence of alexithymia in medical, psychiatric and healthy populations, but have not been investigated in cancer patients. In the oncology setting some researchers argue that alexithymia might be linked to the onset of cancer, based on the hypothesis of a relationship between personality and cancer and the dysregulating effect of alexithymia on the immune system [22,23,24]; others suggest that alexithymia might be a reaction to a life-threatening disease. It is important to further investigate alexithymia in cancer patients, for example because of its potential influence on cancer development and progression, on compliance and on underestimation of psychological suffering and psychiatric outcome.…”

The Assessment of Alexithymia in Medical Settings: Implications for Understanding and Treating Health Problems

“…One study found reduced cytotoxic lymphocyte counts in alexithymic compared to nonalexithymic men (Dewaraja et al, 1997), and another found that alexithymia was related to lower levels of interleukin-4 in women . In two other studies, alexithymia was related to reduced lymphocyte levels and to the presence of precancerous cervical lesions among women undergoing diagnostic testing (Todarello et al, 1997(Todarello et al, , 1994. These latter studies are particularly important because alexithymia was linked to both a potential physiologic mediating pathway (reduced lymphocytes) as well as a disease endpoint (precancerous cells) in people who were asymptomatic and unaware of their diagnosis.…”