Toronto Alexithymia Scale Scores Research Articles

An important contributing factor in dry eye disease: somatization.

Somatization is an important mental process that may causes medically unexplained and treatment-resistant somatic symptoms. The aim of the study is assess the presence of somatization in patients with dry eye disease (DED). Eighty-eight patients with no objective DED finding and ongoing DED treatment were included in this prospective and observational study. Patients with subjective symptoms formed the symptom group and patients without subjective symptoms formed the control group. All patients were scored with the Turkish version of the Ocular Surface Disease Index (OSDI), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Symptom Checklist-90-R (SCL-90R) somatization subscale, Toronto Alexithymia Scale (TAS), Pain Catastrophizing Scale (PCS), and Symptom Interpretation Questionnaire (SIQ). Mean OSDI score was significantly higher in the symptom group than in the control group. The mean HAM-D and HAM-A outcomes did not differ between the groups. The mean SCL-90R somatization subscale, TAS, and PCS scores were significantly higher in the symptom group than in the control group. In the SIQ, somatic attributional style score was significantly higher in the symptom group than in the control group. The SCL-90R somatization subscale, PCS, and somatic attributional style scores had positive and mild-moderate correlation with OSDI scores in the symptom group. The TAS score had positive and moderate correlation with OSDI scores in all sample analyses. Somatization should be considered in patients with DED with chronic ocular surface symptoms. Presence of subjective symptoms resistant to treatment may be an indicator of somatization.

Is Interoception Deficit Linking Alexithymia and Eating Spectrum Symptoms? Study on a Non-Clinical Sample of Young Adults.

We investigated if interoceptive deficits could be the link between alexithymic traits and eating spectrum manifestations in a non-clinical sample. One-hundred sixty-one young adults (mean age: 23.2 ± 2.4 years) were evaluated with the Toronto Alexithymia Scale-20 (TAS-20), the Interoceptive Accuracy Scale (IAS), the Interoceptive Confusion Questionnaire (ICQ), and the Eating Attitudes Test-26 (EAT-26). Questionnaires were administered with an online procedure (Microsoft Form, Office 365 A1, Pisa, Italy) (Study Protocol #0012005/2023). We compared ICQ, IAS, and TAS-20 scores in subjects who met the threshold for a potential eating spectrum disorder according to EAT-26 scores ≥ 20 (n = 27) vs. subjects who scored <20 (n = 134), with an ANCOVA corrected for 'age' and 'gender'. Subjects with EAT-26 ≥ 20, scored significantly higher at ICQ (54.4 ± 13.2 vs. 50.2 ± 6.8; p = 0.011), TAS-20 'Total Score' (60.8 ± 11.9 vs. 58.1 ± 9.2; p = 0.006), and TAS-20 'Identifying Feelings' (21.5 ± 7.6 vs. 17.3 ± 5.8; p = 0.0001). A binary logistic regression analysis, with EAT-26 scores < 20 vs. ≥20 as the dependent variable, and ICQ, IAS, TAS-20 total scores and dimensions, age, and gender (categorical) as covariates, showed that the only variable predicting eating spectrum symptomatology was 'ICQ Total Score' (OR = 1.075, 95% CI: 1.016-1.139; p = 0.013). Interoceptive confusion was the dimension linking the occurrence of alexithymic traits and eating spectrum manifestations.

Characteristics and correlation of gray matter volume and somatic symptoms in adolescent patients with depressive disorder.

Adolescent patients with depressive disorders commonly exhibit somatic symptoms, which have a significant negative impact on their treatment and prognosis. Despite this, specific brain imaging characteristics of these symptoms have been poorly studied. The Hamilton Depression Rating scale (HAMD-17), Children's Functional Somatization scale (CSI), and Toronto Alexithymia scale (TAS) were used to evaluate the clinical symptoms of adolescent depression. We analyzed the correlation between brain gray matter volume (GMV) and clinical symptoms in adolescent patients with depression and somatic symptoms. The depression subgroups with and without functional somatic symptoms (FSS) had higher scores on the HAMD-17, CSI, and TAS than the normal control group. The group with FSS had higher HAMD-17, CSI, and TAS scores than the depression group without FSS (p < 0.05). CSI and TAS scores were positively correlated (r = 0.378, p < 0.05). The GMV of the right supplementary motor area was higher in the depression groups with and without FSSs than in the normal control group, and the GMV was higher in the group without FSS than in the group with FSS (F = 29.394, p < 0.05). The GMV of the right supplementary motor area was negatively correlated with CSI in the depressed group with FSS (r = -0.376, p < 0.05). In the group with depression exhibiting FSS, CSI scores were positively correlated with GMV of the middle occipital gyrus (pr = 0.665, p = 0.0001), and TAS scores were positively correlated with GMV of the caudate nucleus (pr = 0.551, p = 0.001). Somatic symptoms of adolescent depressive disorder are associated with alexithymia; moreover, somatic symptoms and alexithymia in adolescent patients with depressive disorders are correlated with GMV changes in different brain regions.

Is Alexithymia Associated With Sleep Disturbances, Independent of Depression and Anxiety?

Objectives: We aimed to examine the relationship between alexithymia and sleep, independent of depression and anxiety.Methods: This cross-sectional study included participants who visited our sleep clinic between 2016 and 2022. In total, 142 participants (98 males and 44 females) were included, and they completed the Toronto Alexithymia Scale-20 (TAS-20). Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI) scores were also recorded. The relationship between alexithymia and sleep (PSQI, ISI, and ESS scores) was determined after controlling for demographic and psychological (Beck Depression Inventory and State Trait Anxiety Inventory-Trait) variables.Results: Individuals with alexithymia had significantly higher PSQI, ESS, and ISI scores than those without alexithymia. Correlation analysis showed significant correlations between the total TAS-20 score and ISI (r=0.321) and ESS (r=0.253) scores. In multivariate linear regression analysis, the total TAS-20 score (β=0.201; &lt;i&gt;p&lt;/i&gt;=0.022) was significantly associated with the ESS score.Conclusions: Alexithymia was associated with the severity of insomnia and daytime sleepiness in adults. However, when considering depression and anxiety in multivariate analysis, alexithymia was significantly associated with daytime sleepiness; however, its relationship with the severity of insomnia was not significant.

Changes of adrenocorticotropic hormone rhythm and cortisol circadian rhythm in patients with depression complicated with anxiety and their effects on the psychological state of patients.

Objective: This work was to explore the rhythm of adrenocorticotropic hormone (ACTH) and cortisol in patients with depression and anxiety and their effects on mental state. In this work, with depression complicated with anxiety patients as the A-MDD group (n = 21), and depression without anxiety symptoms as the NA-MDD group (n = 21). Firstly, data features were extracted according to the electroencephalo-graph (EEG) data of different patients, and a DR model was constructed for diagnosis. The Hamilton Depression Scale 24 (HAMD-24) was employed to evaluate the severity, and the ACTH and cortisol levels were detected and compared for patients in the A-MDD group and NA-MDD group. In addition, the psychological status of the patients was assessed using the Toronto Alexithymia Scale (TAS). As a result, the AI-based DR model showed a high recognition accuracy for depression. The HAMD-24 score in the A-MDD group (31.81 ± 5.39 points) was statistically higher than the score in the NA-MDD group (25.25 ± 5.02 points) (P < 0.05). No visible difference was found in ACTH levels of patients in different groups (P > 0.05). The incidence of cortisol rhythm disorder (CRD) in the A-MDD group was much higher (P < 0.05). The differences in TAS scores between the two groups were significantly statistically significant (P < 0.01). In conclusion, the AI-based DR Model achieves a more accurate identification of depression; depression with or without anxiety has different effects on the mental state of patients. CRD may be one of the biological markers of depression combined with anxiety.

Resilience mediates the association between alexithymia and stress in Chinese medical students during the COVID-19 pandemic

BackgroundEvidence indicates that medical students have had high rates of mental health problems, especially during the COVID-19 pandemic, which could be affected by alexithymia—a marked dysfunction in emotional awareness, social...

Alexithymia and related factors among patients with epilepsy

ObjectiveAlexithymia is a psychiatric symptom characterized by difficulties in emotion recognition, expression, and regulation. The purpose of our study was to investigate the prevalence of alexithymia among patients with epilepsy (PWE) and related factors. MethodsBy the means of a cross-sectional study, we consecutively recruited PWE who visited the First Hospital of Jilin University. The demographical information and clinical data were collected. Toronto Alexithymia Scale-20 (TAS-20), Emotion Regulation Questionnaire (ERQ), Kilifi Stigma Scale for Epilepsy (KSSE), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Generalized Anxiety Disorder-7 (GAD-7), and Nurses' Global Assessment of Suicide Risk scale (NGASR) scales were applied to assess alexithymia, emotion regulation strategies, and the presence of comorbid psychiatric symptoms. ResultsA total of 203 PWE were included. The differences in education, monthly per capita income of the family, and the number of antiepileptic drugs were statistically significant among these three groups with alexithymia, possible alexithymia, and non-alexithymia (p < 0.05). Toronto Alexithymia Scale-20 scores were significantly and positively correlated with BMI (rho = 0.143, p = 0.042). Expression suppression, stigma, and generalized anxiety were independent risk factors for alexithymia (R2 = 0.471, F = 19.075, p < 0.001). ConclusionsA high prevalence of alexithymia (18.7%) was found in PWE. Alexithymia is primarily influenced by the emotional regulation strategies, anxiety, and stigma among PWE. It tends to be a mood symptom or personality trait rather than a direct result of epilepsy.

The Association of White Matter Tracts with Alexithymia among Individuals with Major Depressive Disorder.

Alexithymia is characterized by impairments in the processing of emotions. Although the disruptions in the white matter (WM) integrity in Major depressive disorder (MDD) has frequently been reported, the underlying relationship with alexithymia remains unclear. In the present study, we investigated WM tracts with Tracts Constrained by UnderLying Anatomy approach to discover potential associations between alexithymia and WM integrity to identify the neural basis of impaired emotional self-awareness in MDD. 101 patients with MDD and 99 healthy sex- and age-matched individuals underwent diffusion-weighted imaging. All participants were assessed with the 20-item Toronto Alexithymia Scale (TAS). TAS scores were significantly higher in MDD patients than in controls. Patients with MDD exhibited significantly lower FA values in the left inferior longitudinal fasciculus and it also showed negative associations with TAS. These results contribute to the neurobiological evidence on the association between MDD and alexithymia. Additionally, they suggest that reduced white matter integrity in the regions constitutes a principal pathophysiology underlying impaired emotional recognition and description in MDD.

Impulsivity and alexithymia predict early versus subsequent relapse in patients with alcohol use disorder: A 1-year longitudinal study.

Longitudinal psychopathological predictors of relapse in alcohol use disorder are unclear. Relapses, sociodemographic and psychopathological risk factors were assessed in 171 alcohol use disorder outpatients within a 1-year follow up. Impulsivity and alexithymia were evaluated using the Barratt Impulsiveness Scale and the Toronto Alexithymia Scale, respectively. At endpoint, 39% of patients maintained abstinence, 30.9% relapsed at ≤1month from detoxification (early), 30.1% at >1month (subsequent). Baseline Barratt Impulsiveness Scale score was predictive of early versus subsequent relapse (odds ratio 1.12, p=0.005) and versus abstinence (odds ratio 1.17, p < 0.001). Toronto Alexithymia Scale score was a risk factor for subsequent versus early relapse (odds ratio 1.13, p=0.003) and versus abstinence (odds ratio 1.21, p < 0.001). Impulsivity predicted relapse within the first 4-weeks; alexithymia showed delayed effects. Time-varying effects of specific relapse factors emphasise the need for preliminary careful assessment and personalised interventions to promote long-term abstinence.

Depression in Chinese men with methamphetamine dependence: Prevalence, correlates and relationship with alexithymia

BackgroundThe comorbidity between substance use disorder and major depressive disorder is a typical dual diagnosis in the field of substance addiction. However, the prevalence and correlates of depression in methamphetamine addicts and whether it is associated with drug craving and alexithymia have been rarely reported in the Chinese population. MethodsWe recruited 585 methamphetamine-dependent males from a drug rehabilitation center in China and 203 healthy controls. Demographic and drug use data were collected. Depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N·I.). Methamphetamine cravings and alexithymia were assessed using the Desire for Drugs Questionnaire (DDQ) and the Toronto Alexithymia Scale (TAS). ResultsThe prevalence rate of depression in methamphetamine-dependent men was 16.58 % (97/585). The scores of DDQ desire and intention, DDQ negative reinforcement, total DDQ, difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and total TAS score of depressed patients were higher than those of non-depressed patients. However, only DDQ negative reinforcement score, DIF, DDF, and total TAS score remained significant after Bonferroni correction. Additionally, logistic regression analysis found that age, DIF score, and DDQ negative reinforcement score were significant factors contributing to depression in methamphetamine-dependent men. ConclusionOur findings suggest that the prevalence of depression is significantly higher in methamphetamine-dependent men than in the healthy Chinese population. Furthermore, age, components of alexithymia and drug craving are risk factors for depression in methamphetamine addicts.

White matter tracts associated with alexithymia and emotion regulation: A diffusion MRI study

BackgroundAlexithymia is a cognitive-affective impairment, suggested to be associated with emotion regulation. Herein, we investigated white matter (WM) tracts with Diffusion Magnetic Resonance Imaging (DMRI) connectometry approach using quantitative anisotropy (QA) tractography to discover possible associations between the emotion identification and regulation patterns and WM tracts. MethodsDMRI data were acquired from 218 healthy subjects aging 39.15 ± 20.19 who filled the Toronto Alexithymia Scale (TAS) and emotion regulation questionnaire (ERQ) from the LEMON dataset. Connectometry analysis was applied on WM tracts in DMRI images. ResultsDMRI connectometry analysis revealed a significant correlation between TAS identification score and increased microstructural connectivity in WM pathways, including the body of corpus callosum (CC), bilateral fornix, and left arcuate fasciculus (AF) in males (FDR = 0.028), and corticospinal and cingulum tracts in females (FDR = 0.026). Furthermore, we found a significant positive correlation between overall TAS score and fornix properties in men (FDR = 0.026) and corticospinal tracts in women (FDR = 0.028). Middle cerebellar peduncle negatively correlated with describing emotion (FDR = 0.025) and the splenium of the CC and corticospinal tracts negatively correlated with this subscale (FDR = 0.049) in male group. However, the splenium of the CC, corticospinal tracts, and left AF positively associated with this subscale (FDR = 0.029). The splenium of the CC was negatively related to externally-oriented thinking among men (FDR = 0.038). Our results showed marginally associations between ERQ and similar WM tracts. ConclusionCertain WM microstructures significantly correlate with emotion identification and regulation. These tracts are associated with specific somatosensory areas, language processing areas, and limbic area.

Associations between alexithymia, parental rearing styles, and frequency of drug use in male methamphetamine dependence patients

BackgroundAlexithymia, which is characterized by difficulty identifying and describing feelings, is a stable personality trait and it has been associated with early life experiences. Methamphetamine dependence patients with high level of alexithymia may be particularly vulnerable to engaging in more frequent methamphetamine use. Therefore, we aimed to evaluate whether alexithymia was associated with frequency of methamphetamine use. Additionally, the current study sought to examine early-life factors associated with the development of alexithymia, i.e., parental rearing styles.MethodParticipants were 108 non-injecting methamphetamine dependent patients from a male compulsory detoxification center. The level of alexithymia was assessed by Toronto Alexithymia Scale-20(TAS-20). In addition, we applied Egna Minneu av. Bardndosnauppforstran (EMBU) to assess the parental rearing styles, including the dimensions of warmth, rejection, punishment/strictness, overinvolvement, overprotection, and favoring.ResultsThe total score of TAS-20 was positively correlated with frequency of methamphetamine use (r = 0.26, p < 0.01). Specifically, except for externally oriented thinking, difficulty identifying feelings (r = 0.23, p < 0.05) and difficulty describing feelings (r = 0.25, p < 0.05) were positively correlated with frequency of methamphetamine use. Multiple linear regression showed that more maternal rejection (B = 0.59, p = 0.002), or less maternal warmth (B = -0.22, p = 0.004) was associated with higher levels of alexithymia. Ordinal logistic regression showed that for every 1 score increase in the total score of TAS-20, there was a 1.06 times risk of a one level increase in the level of methamphetamine use frequency (OR = 1.06, p = 0.01).ConclusionsThese results have major implications for understanding the role of alexithymia in craving and addiction, while providing a further and explicit entry point for addiction treatment. Moreover, more attention should be focused on parenting in relation to early experiences.

Eliciting Expressions of Emotion: An Exploratory Analysis of Alexithymia in Adults with Autism Utilising the APRQ

This study examined alternative methods for detecting alexithymia to the Toronto Alexithymia Scale—20 (TAS-20) by comparing the emotional linguistic performance of ASD and NT samples (n = 32 in each) on the Alexithymia Provoked Responses Questionnaire (APRQ). We utilised both the LIWC and tidytext approaches to linguistic analysis. The results indicate the ASD sample used significantly fewer affective words in response to emotionally stimulating scenarios and had less emotional granularity. Affective word use was correlated with ASD symptomatology but not with TAS-20 scores, suggesting that some elements of alexithymia are not well detected by the TAS-20 alone. The APRQ, in combination with the tidytext package, offers significant potential for sophisticated exploration of emotional expression in ASD.

Different dissociation and alexithymia domains specifically relate to patients with psychogenic non-epileptic seizures (PNES) and with PNES and comorbid epilepsy (PNES+EP)

• We investigated dissociation and alexithymia in psychogenic non-epileptic seizures (PNES). • We compared four samples: patients with PNES, PNES with epilepsy (EP), EP and healthy controls. • Dissociative experiences Scale-II (DES-II) and Toronto alexithymia Scale-20 (TAS-20) totals did not predict TAS-20 and DES-II totals, respectively. • In PNES sample, depersonalization/derealization (Dep/Der) was fully mediated by difficulty identifying feelings (DIF) and absorption (Abs) in predicting difficulty describing feelings (DDF). • In PNES with EP sample, DEP/DER was partially mediated by ABS in predicting DDF. Several studies previously examined the role of dissociation and alexithymia in patients with psychogenic non-epileptic seizures (PNES). However, their relationship remains unclear. We administered questionnaires for dissociation (DES-II), alexithymia (TAS-20), anxiety and depression to 57 subjects: 14 patients with PNES, 13 patients with comorbid PNES and epilepsy (PNES+EP), 14 patients with EP and 16 healthy controls. For between-group comparisons we applied Chi-square test, ANOVA and Kruskal-Wallis. The Spearman correlations, hierarchical regression analyses and path models, goodness-of-fit indices and maximum-likelihood estimates of model parameters were obtained through SPSS 27 and AMOS 27. Hierarchical regression analyses showed that nor DES-II neither TAS-20 total scores were able to predict TAS-20 and DES-II total scores, respectively, possibly due to subscale score pooling. Following modification indexes of AMOS 27, in PNES sample, we found that only Depersonalization/Derealization (Dep/Der) was fully mediated by Difficulty Identifying Feelings (DIF) and Absorption (Abs) in predicting Difficulty Describing Feelings (DDF), and a partial effect of DIF and Dep/Der implement DDF, while both DIF and DDF implement Abs. In PNES+EP group, Dep/Der was able to predict DDF, with a partial mediation of Abs that predicted Externally Oriented Thinking, while DDF was able to promote Abs, and DIF effect on Abs was fully mediated by Amnesia (Amn). Our study is cross-sectional, participants were self-selected and the data were derived from self-report measures. Conclusions: In PNES, Dep/Der and DIF may play a prominent role, while in PNES+EP, Dep/Der, Abs, DIF and Amn may be involved. Clinical implications are discussed.

Роль алекситимии в клинической картине хронической неспецифической тазовой боли у женщин

The purpose was to evaluate the impact of alexithymia on the severity of clinical manifestations of chronic nonspecific pelvic pain (CNPP) in women. Material and methods. The study included 138 women with CNPP. All patients underwent a neurological examination, assessment of pain intensity using a visual analog scale (VAS), assessment of the level of alexithymia using the Russian version of the 20-item Toronto Alexithymia Scale (TAS). Pharmacotherapy of CNPP included the following sequential prescription: aceclofenac 100 mg, 2 times a day for 7 days, tolperisone 150 mg, 3 times a day for 2 weeks, escitalopram 5 mg, once a day for 2 months. Results. The patients were divided into 2 groups: group A (n = 101) — without alexithymia, group B (n = 37) — with alexithymia (average TAS score = 74 [65; 85]). A positive correlation was established between the level of alexithymia and the intensity of pain according to the VAS in patients of group B. According to the effectiveness of pharmacotherapy, patients of group A were divided into 3 subgroups A1, A2, A3. In subgroup A1, the intensity of pain decreased to 30 [20; 40] mm (p = 0.0032) after taking aceclofenac. In subgroup A2, pain decreased to 30 [10; 40] mm (p = 0.0042) after taking tolperisone. In the A3 subgroup, pain decreased 0 [0; 5] mm (p = 0.012) after taking escitalopram. In patients of group B, no effect of pharmacotherapy was noted. After the completion of pharmacotherapy, the patients were recommended kinesitherapy, after which the patients of group B experienced a decrease in pain to 40 [30; 45] mm (p = 0.00021), and a decrease in the level of alexithymia to 50 [45; 60] points (p = 0.0023 ). Conclusion. Patients with CNPP are low sensitive to traditional pharmacotherapy of pain, including drugs of peripheral and central action. Kinesitherapy has a positive effect, including stretching exercises and relaxation of skeletal muscles.

The relationship between alexithymia and clinical features in rhinoplasty patients

The present study aimed to investigate the incidence of alexithymia in rhinoplasty patients before and after surgery, and to increase the value of alexithymia analysis. The study also aimed to evaluate self-esteem and rhinoplasty outcome scores together. Patients who had undergone rhinoplasty were enrolled in the study, and they were grouped according to gender, marital status, working status, indication (functional or aesthetic), and type of surgery (primary or revision). Toronto Alexithymia Scale-20 (TAS-20), Rosenberg Self-Esteem Scale (RSES), Rhinoplasty Outcome Evaluation (ROE), and Nasal Obstruction Symptom Evaluation (NOSE) surveys were used to assess their relationship with alexithymia. We observed significantly higher alexithymia and lower self-esteem scores in females, widows, those with aesthetic indication, those who required revision surgery, and those who had never worked, and a significant correlation was observed except for marital status (p<0.05). After the surgery, significant improvement was found in TAS-20 and RSES according to preoperative scores (p<0.05). There was a significant inverse correlation between TAS-20 and ROE scores, while a positive correlation was observed between RSES and ROE scores (p<0.05). This is the first study to investigate alexithymia changes in rhinoplasty candidates. TAS-20 can be considered as a useful survey to assess psychological distress in rhinoplasty candidates.

The Relationship of Smartphone Addiction and Alexithymia.

ObjectiveThis study aims to evaluate whether smartphone addiction (SA) is associated with social media use and alexithymia levels in university students. MethodsA group of 935 students aged between 18 and 45 years (509 females and 426 males) was recruited from different universities in Istanbul. SAs, alexithymia and social media use were assessed using the Smartphone Addiction Scale Short Version (SAS-SV), Toronto Alexithymia Scale-20 (TAS-20), and ad-hoc questions regarding social media use. ResultsThe mean age of participants was 21.89±3.27 years and 509 of participants were female (54.4%). 455 (48.6%) participants were placed in the “SA” and 198 (21.2%) in the “alexithymia” categories. The study found a high level of positive correlation (p<0.001) between both subscale and total TAS-20 scores and SAS-SV scores. Gender (OR=1.496, 95% CI 1.117–2.002, p=0.007) and number of social media by participants (OR=1.221, 95% CI 1.134–1.315, p<0.001) and TAS (OR=1.074, 95% CI 1.059–1.090, p<0.001) were found to be an independent predictors for SA. ConclusionThe study revealed a positive correlation between alexithymia and smartphone use severity, and alexithymia was a significant predictor of SA. Future studies focusing on the causal aspect of this relationship will be useful in planning strategies for treatment.

The Relationship Between Alexithymia and Risk for Postpartum Depression

Coronavirus disease 2019 (COVID-19) is classified as a stressful life experience. The aim of this study was to assess the levels of alexithymia and risk for postpartum depression in women during the COVID-19 pandemic and state-of-emergency lockdown in Serbia. This cross-sectional study included 108 adult (age ≥18 years) postpartum women with children age 12 months or younger. We used the following questionnaires: Edinburgh Post-natal Depression Scale (EPDS), Toronto alexithymia scale (TAS), Hamilton scale for the assessment of anxiety (HAM-A) and depression (HAM-D), and an additional questionnaire constructed for this study. We found that 14.8% of participants had a score of 10 or higher on EPDS, 23.15% had alexithymia, and 31.32% had borderline alexithymia. There was a significant positive correlation of alexithymia with risk for postpartum depression, high-intensity anxiety, and depression in postpartum women with a score of 10 or higher on HAM-D and 18 or higher on HAM-A. Higher rates on TAS were noticed in mothers who were older, single, and dissatisfied with emotional status, with lower educational level, unemployment, and lack of family support. Multiple linear regression analysis including all factors that correlate with higher TAS scores showed that higher scores on HAM-D (beta = 0.75, P &lt; .01) and higher scores on EPDS (beta = 0.69; P &lt; .01) were independent predictors of higher EPDS scores (adjusted R 2 = 0.52, P &lt; .01 for overall model). Alexithymia could develop in response to pandemics, and pandemics and the measures taken to combat a pandemic could be considered as risk factors for postpartum depression. [ Psychiatr Ann . 2021;51(9):431–436.]

The impact of clinical and psychological characteristics on alexithymia in type 1 diabetes

Background: Alexithymia is a psychological construct characterized by inability to express emotions, poor imagination and operational thinking. It is well known its association with several chronic disease such as Diabetes type 2, little is known about diabetes type 1. We examined the association of alexithymia with clinical and psychological outcomes in subjects with type 1 diabetes. Methods: The study was conducted in a single diabetes center. The patients fully completed a protocol composed of the following instruments: the Toronto Alexithymia Scale-20 (TAS-20), the State-Trait Anger Expression Inventory-2 (STAXI-2), the State-Trait Anxiety Inventory form Y (STAI-Y), and the Hamilton Rating Scale for Depression (HAMD). TAS-20 scores were subdivided into tertiles, Correlations and two linear regression analyses, adjusted for only clinical and clinical plus psychological characteristics, were performed. Overall, 75 patients were enrolled (mean age 41.0±11.4 years, diabetes duration 19.9±11.9 years, 49.3% males, 30.7% treated with CSII). Results: People with diabetes of the upper TAS-20 tertile had the greatest rate of depression (with the highest degree of severity) and the higher levels of anger and anxiety. There was a significant correlation between TAS-20 scores with BMI (r=0.26; p=0.03), HAMD (r=0.38; p=0.001), STAXI-2 (r=0.34; p=0.003) and STAI-Y (r=0.48; p<0.0001). Further regression analysis showed TAS-20 scores were associated with BMI (beta=0.29; p=0.02). The association with BMI was confirmed (beta=0.28; p=0.007) when psychological variables are considered; furthermore, a strong association with STAI-2 (beta=0.48; p<0.0001) was detected, while the analysis did reveal any significant correlation between alexithymia and HbA1c levels. Conclusions: Alexithymia is strongly associated both with clinical and psychological characteristics, notably with BMI and anxiety traits. People with diabetes type 1 should be assessed for alexithymia. Future studies on the current topic are therefore required in order to elucidate the role of alexithymia in diabetes type 1. We believe that patients with diabetes and alexithymia could take advantage of psychological counseling.

Alexithymia is associated with reduced vitamin D levels, but not polymorphisms of the vitamin D binding-protein gene.

Alexithymia is a personality trait characterized by difficulties in identifying and describing emotions, which is associated with various psychiatric disorders, including depression and posttraumatic stress disorder (PTSD). Its pathogenesis is incompletely understood but previous studies suggested that genetic as well as metabolic factors, are involved. However, no results on the role of vitamin D and the polymorphisms rs4588 and rs7041 of the vitamin D binding protein (VDBP) have been published so far. Serum levels of total 25(OH)D were measured in two general-population samples (total n = 5733) of the Study of Health in Pomerania (SHIP). The Toronto Alexithymia Scale-20 (TAS-20) was applied to measure alexithymia. Study participants were genotyped for rs4588 and rs7041. Linear and logistic regression analyses adjusted for sex, age, waist circumference, physical activity, season and study and, when applicable, for the batch of genotyping and the first three genetic principal components, were performed. In sensitivity analyses, the models were additionally adjusted for depressive symptoms. 25(OH)D levels were negatively associated with TAS-20 scores (β = -0.002; P < 0.001) and alexithymia according to the common cutoff of TAS-20>60 (β = -0.103; P < 0.001). These results remained stable after adjusting for depressive symptoms. The tested genetic polymorphisms were not significantly associated with alexithymia. Our results suggest that low vitamin D levels may be involved in the pathophysiology of alexithymia. Given that no associations between alexithymia and rs4588 as well as rs7041 were observed, indicates that behavioral or nutritional features of alexithymic subjects could also explain this association.