<p>Alexithymia in Patients with Psoriasis: A Cross-Sectional Study from Ecuador</p>

Abstract

ObjectiveWe designed this study to determine the frequency of alexithymia in Ecuadorian patients with psoriasis, as well as possible associations between demographic factors, disease severity, and treatment adherence.MethodsA cross-sectional study involving 99 Ecuadorian patients with psoriasis was conducted. Multinomial logistic regressions were performed to ascertain whether age, gender, educational level, years with disease, psoriasis area and severity index (PASI) scores, and treatment adherence categories are prediction factors in patients with psoriasis to present alexithymia, possible alexithymia or no alexithymia.ResultsA total of 99 patients participated in the study with a gender distribution of 57.6% male, and an average age and years with disease of 48.3 and 7.4, respectively. Out of all patients, 33.3% presented alexithymia, and 22.2% possible alexithymia, as assessed by the Toronto Alexithymia Scale (TAS-20). The multiple regression model statistically significantly predicted the TAS-20 score from age, gender, educational level, years with psoriasis, PASI score and level of adherence F (7,88) = 4.171, p = 0.001, adj. R2= 0.189. Only having the highest educational level added statistical significance to the prediction of having a lower TAS-20 score, whilst the remainder variables did not.ConclusionWe found a similar proportion of alexithymia, as well of average TAS-20 scores among Ecuadorian patients with psoriasis in comparison to previous studies. Only having the highest educational level was found to decrease the TAS-20 score. Age, gender, years with psoriasis, PASI score and level of adherence were not identified as factors that influence the TAS-20 score.

The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis

“…Moreover, alexithymic patients with psoriasis also have a lower level of school education in comparison with non-alexithymic patients. Similarly, Cherrez-Ojeda et al [ 17 ] found the highest education level to predict lower alexithymia in patients with psoriasis. This result is consistent with those of previous studies (e.g., [ 46 , 47 ]), which hypothesized the presence of an educational bias; higher education is linked to better expressive skills, whereas lower education is related to less understanding of emotional states and disclosure.…”

“…Alexithymia is a personality trait encompassing a difficulty in identifying and describing feelings as well as an externally oriented thinking [ 16 ]. Several studies found a high prevalence of alexithymia in patients with skin diseases, including psoriasis [ 17 , 18 , 19 , 20 ]. For example, alexithymic patients with psoriasis had a poorer quality of life, higher anxiety and depression scores, and a higher risk of alcohol dependency compared to patients with less severe alexithymic traits [ 20 ].…”

Alexithymia and Cutaneous Disease Morbidity: A Systematic Review

“…Age, geographic location, disease duration, and severity did not appear to influence prevalence or severity of alexithymia; but, alexithymic patients were reported to experience a higher burden of psoriasis (PASI >10) compared to non-alexithymic patients [33, 36, 39-41]. Involvement of sensitive areas (hands, face, neck, and/or genitals), lower education level, unemployment, and higher body mass index (BMI) were positively associated with alexithymia [33, 35, 36, 38, 40]. While a majority of studies found the TAS-20 total score not to be significantly influenced by gender [33, 36, 39, 41], one study of 250 patients reported a positive association between logistical regression of alexithymia and female sex (male to female odds ratio: 0.21) [40].…”

“…A minority of smaller studies, some using assessments other than the TAS-20 questionnaire, reported a 5-29.4% prevalence of clinically significant alexithymia in patients [31,32]. Studies consistently using the TAS-20 questionnaire (86.7%) and accounting for 3,132 patients suggested the prevalence of clinically significant alexithymia in patients to be higher, between 36.2% and 67.7% [33][34][35][36][37][38][39][40].…”

“…Age, geographic location, disease duration, and severity did not appear to influence prevalence or severity of alexithymia; but, alexithymic patients were reported to experience a higher burden of psoriasis (PASI >10) compared to non-alexithymic patients [33,36,[39][40][41]. Involvement of sensitive areas (hands, face, neck, and/or genitals), lower education level, unemployment, and higher body mass index (BMI) were positively associated with alexithymia [33,35,36,38,40].…”