Prevalence of alexithymia and its association with anxiety and depression in a sample of Greek chronic obstructive pulmonary disease (COPD) outpatients

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is a major health problem, especially in adults over 40 years of age, and has a great social and economic impact. The psychological morbidity of COPD patients with regard to anxiety and depressive symptoms has been extensively studied in the past. However, few studies have investigated the prevalence of alexithymia in these patients, as well as its association with this comorbidity. Based on this fact, we studied the prevalence of alexithymia and its association with anxiety and depressive symptoms in COPD outpatients.MethodsThe present study included 167, randomly selected, outpatients diagnosed with COPD. Alexithymia, anxiety and depression were assessed using the Toronto Alexithymia Scale (TAS-20), Spielberger Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively.ResultsThe mean BDI score was 12.88 (SD: 7.7), mean STAI score 41.8 (SD: 11.0) and mean TAS-20 score 48.2 (SD: 11.5). No differences were observed between genders regarding age and alexithymia (t test P > 0.05), while female patients presented higher depression and trait anxiety scores than males (t test P < 0.05). Clinically significant levels of anxiety were present in 37.1% of men, and in 45.7% of women. The mean depression score was also higher than the corresponding mean score in the general population (one-sample t test P < 0.01), while 27.7% and 30.5% of the sample presented mild and moderate to severe depression, respectively. Finally, a strong correlation was observed between alexithymia, depression and anxiety.ConclusionsThis study confirms the high prevalence of anxiety and depression symptoms in Greek outpatients with COPD. The prevalence of alexithymia in COPD patients, contrary to what has been observed in patients with other chronic respiratory diseases, seem to be lower. However, we observed a strong association between alexithymia, depression and anxiety levels. This observation suggests that alexithymia should be taken into consideration when drafting specific psychotherapeutic interventions for these patients.

A pulmonary rehabilitation program reduces levels of anxiety and depression inCOPD patients

“…The fact that the predicted FEV 1 % and severity of COPD showed no correlation with anxiety or depression has been observed in other studies [6,68]. These observations are consistent with the hypothesis that the predicted FEV 1 % does not reflect all aspects of the disease [69].…”

“…Finally, the positive correlation between anxiety and depression is a common finding in both the general population [5,20] and in patients with COPD [1,6,68]. …”

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

“…Another factor that may have affected our results is the cut-off point of o19 in the BDI score that we selected for the distinction between patients with and without clinically important depressive symptoms. A previous validation study in the Greek general population [30] and a cross-sectional study in COPD patients have used different cut-off points [15]. However, we decided to use the cut-off from the original publication by BECK et al [13] which distinguishes patients with minimal or mild depressive symptoms from patients with moderate or severe depressive symptoms.…”

“…This cut-off point was previously used in a recent prospective study that enrolled COPD patients in a similar design to our study [14]. The Greek version of the BDI has been validated in the Greek population and has been evaluated recently in Greek COPD patients [15]. The official translation of BDI was provided by the Hellenic Institute of Psychology and Health (www.ipsy.gr).…”

Alexithymia and fertility-related stress

“…Total scores range from 20 to 100. The TAS-20 is used worldwide for measuring alexithymia, and the empirically established cut off of ≥61 (Bagby & Taylor, 1997) was used in this study as this cut-off score has been used in a previous Greek study (Tselebis et al, 2010). A validated Greek version of the TAS-20 was used (Anagnostopoulou & Kioseoglou, 2002).…”