The Relationship Between Alexithymia and Depression in Patients with Multiple Sclerosis

Abstract

M ultiple Sclerosis (MS) is a chronic, progressive, demyelinating disorder of the Central Nervous System (CNS), seen mostly in young adolescents and early adulthood and it may result in physical disability. [1] Neuropsychiatric symptoms such as depression, fatigue, anxiety, cognitive impairment and alterations in personality can be seen in MS patients. They are usually seen concomitantly, and it is important to discriminate these symptoms in order to give the appropriate treatment. [1,2] Depression is the most prominent symptom seen in these patients and the prevalence was found to be %30.5 in a recent meta analyses. [2] There are many studies investigating the role of alexithymia in depression. [3] Although there are several studies reporting a close relationship between alexithymia and depression , there is no clear opinion whether these two are distinctive from one another or overlapping. [3] Alexithymia means 'Greek a(α-)= absence, inadequacy; lexis(λεξιζ)=-word; thymos (θυμοζ)=feeling'. Sifneos was the first to define alexithymia in patients with psychosomatic disorders. He defined that these patients as patients having difficulty in defining, discriminating and putting their feelings and thoughts in words; had limited fantasy worlds and mostly focused on outer world realities than their own feelings during the therapy. Alexithymia prevalence in multiple sclerosis is not clear since it is mostly seen together with other psychological conditions. [4] The aim of this study is to investigate the relationship between depression and alexithymia in MS. Objectives: A number of psychiatric disorders emerge during the disease course in Multiple Sclerosis (MS). Depression being the most reported disorder; up to date studies showed no clear relationship between alexithymia and depression in these patients. The aim of this study is to investigate the relationship between alexithymia and depression in MS. Methods: 40 patients between ages 18 and 55 admitted to the Neurology Clinic in Okmeydani Training and Research Hospital who were diagnosed with Relapsing Remitting Multiple Sclerosis (RRMS) according to 2010 Mc Donald's criteria and 40 healthy volunteers participated in this study. All subjects had given written consent. Depression and alexithymia status were assessed with Beck Depression Scale (BDS) and Toronto Alexithymia Scale (TAS) respectively. Results: BDS and TAS scores were found significantly higher in MS group especially in women compared to men (p<0.05). It was also observed that alexithymia levels showed increase with high EDSS scores and longer disease period (p<0.05). Conclusion: In this study, it was observed that depression and alexithymia were related with MS.

Alexithymia and Coping With Stress in Patients With Multiple Sclerosis: A Comparative Study

“…It was stated that atrophy and lesions in the prefrontal cortex affecting the ventromedial and dorsolateral regions were linked to emotion processing, alexithymia, and empathy in MS patients 4. Consistent with the literature, in our study, alexithymia rates were higher in the MS patients compared with the healthy participants 8,24,26. This finding is consistent with the fact that the disease causes neurobiological damage.…”

“…Alexithymia, which is described as the lack of ability of individuals to perceive their or other people's feelings,8 is common in neurological diseases and various psychiatric disorders 23. Consistent with other publications, 41% of our sample had alexithymic symptoms 4,8,24–26. A longitudinal study based on a 5-year period suggested that the frequency of alexithymia in MS patients did not differ over time.…”

“…4 Consistent with the literature, in our study, alexithymia rates were higher in the MS patients compared with the healthy participants. 8,24,26 This finding is consistent with the fact that the disease causes neurobiological damage.…”

“…23 Consistent with other publications, 41% of our sample had alexithymic symptoms. 4,8,[24][25][26] A longitudinal study based on a 5-year period suggested that the frequency of alexithymia in MS patients did not differ over time. In the same study, it was found that the scores of the participants in the subscale of externally oriented thinking, a component of alexithymia, showed a significant decrease after 5 years.…”