The percentage and clinical correlates of alexithymia in stable patients with schizophrenia

Abstract

Alexithymia is a common, but less-recognized affective deficit in patients with schizophrenia. To date, no definitive conclusions have been drawn about the relationship between alexithymia and the clinical symptoms or their clinical correlates, particularly in stable patients with schizophrenia. The purpose of this study was to investigate the link between alexithymia and psychopathological symptoms, as well as any associated correlates, in stable patients with schizophrenia. A total of 435 Chinese patients with schizophrenia were recruited. The Positive and Negative Symptoms Scale (PANSS) was used to evaluate each patient’s psychopathological symptoms. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia. The percentage of alexithymia was 35.2% in stable patients with schizophrenia. Compared to non-alexithymia patients, patients with alexithymia had higher PANSS total scores, negative subscores, depressive subscores, and cognitive subscores (all p < 0.05). Multivariate regression analysis revealed that the following variables were positively associated with TAS-20 total scores: PANSS negative subscores (β = 0.274, t = 3.198, p = 0.001) and PANSS depressive subscores (β = 0.366, t = 2.500, p = 0.013). Education years (β = – 0.453, t = – 2.824, p = 0.005) was negatively associated with TAS-20 total scores. Our results suggest that the percentage of alexithymia was relatively higher in stable patients with schizophrenia. Education levels, negative symptoms, and depressive symptoms were independently associated with alexithymia in this specific population.

Alexithymia in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates, and relationship with neurocognition and empathy

“…Alexithymia was evaluated through the Toronto Alexithymia Scale (TAS‐20), the most widely used measurement scale for alexithymia in schizophrenia (Yi et al, 2022; Zhou et al, 2023). It consists of 20 items and three subscales (i.e., EOT, DIF, and DDF; Schroeders et al, 2022).…”

“…According to a previous study (Yi et al, 2022), a cutoff point of 60 was used to identify patients with alexithymia. The Cronbach's alpha of TAS-20 was 0.71 in our study, indicating reasonable internal consistency.…”

“…In recent years, studies have increasingly demonstrated a significant association between alexithymia and schizophrenia (O'Driscoll et al, 2014; Ospina et al, 2019). Approximately one‐third of patients with schizophrenia could be affected by alexithymia (Yi et al, 2022). Studies have consistently reported higher alexithymia levels in patients with schizophrenia than that in healthy subjects (McGillivray et al, 2017; van't Wout et al, 2007).…”

“…Although some studies identified a negative association between alexithymia and cognition (He et al, 2022; Luo et al, 2021), others reported conflicting results (Gawęda & Krężołek, 2019; Koelkebeck et al, 2010). The relationship between alexithymia and clinical symptoms, particularly negative symptoms, also remains controversial (İnanç et al, 2019; Todarello et al, 2005; Yi et al, 2022).…”

“…In recent years, studies have increasingly demonstrated a significant association between alexithymia and schizophrenia (O'Driscoll et al, 2014;Ospina et al, 2019). Approximately one-third of patients with schizophrenia could be affected by alexithymia (Yi et al, 2022).…”