This review proposes a critical discussion of the recent studies investigating the presence of alexithymia in patients suffering from different chronic pain (CP) conditions. The term CP refers to pain that persists or progresses over time, while alexithymia is an affective dysregulation, largely observed in psychosomatic diseases. Overall, the examined studies showed a high prevalence of alexithymia, especially difficulties in identifying feelings, in all the different CP conditions considered. However, the association between alexithymia and pain intensity was not always clear and in some studies this relationship appeared to be mediated by negative effect, especially depression. The role of alexithymia in CP should be clarified by future studies, paying particular attention to two aspects: the use of additional measures, in addition to the Toronto Alexithymia Scale, to assess alexithymia, and the analysis of the potential differences in the evolution of different CP conditions with reference to the presence or absence of alexithymia.
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Di Tella M, Castelli L, Colonna F, et al. Theory of mind and emotional functioning in fibromyalgia syndrome: an investigation of the relationship between social cognition and executive function. PLoS One. 2015;10:e0116542. One of the six studies investigating the relationship between alexithymia and PRCs, in particular FM. FM patients showed impairments in both regulation of their own affect (alexithymia) and recognition of other’s emotions, as well as in representing other’s mental states.
Baeza-Velasco C, Carton S, Almohsen C, et al. Alexithymia and emotional awareness in females with Painful Rheumatic Conditions. J Psychosom Res. 2012;73:398–400. One of the six studies investigating the relationship between alexithymia and PRCs. All TAS-20 scores were significantly higher among PRC women compared to the HC. Moreover, PRC females had lower capacities to describe their own emotional experience on LEAS.
Vieira RV, Vieira DC, Gomes WB, et al. Alexithymia and its impact on quality of life in a group of Brazilian women with migraine without aura. J Headache Pain. 2013;14:18. The only recent study investigating the relationship between alexithymia and chronic migraine. Women with migraine had higher levels of depression, anxiety and alexithymia, and lower levels of quality of life, self-reflection and insight, compared to the HC.
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Lorys Castelli was supported by University of Turin grants (“Ricerca scientifica finanziata dall’Università” Linea Giovani; http://www.unito.it) and CRT Foundation project “Componenti psicologiche e psicosomatiche nella sindrome fibromialgica”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflicts of Interest
MDT and LC declare that they have no conflicts of interest.
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With regard to the authors’ research cited in this paper, all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. In addition, all applicable international, national, and/or institutional guidelines for the care and use of animals were followed.
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Di Tella, M., Castelli, L. Alexithymia in Chronic Pain Disorders. Curr Rheumatol Rep 18, 41 (2016). https://doi.org/10.1007/s11926-016-0592-x
- Chronic pain
- Emotional processing
- Psychological distress