Alexithymia in fibromyalgia syndrome

The study compared alexithymia in fibromyalgia syndrome (FMS) patients and healthy individuals, and analyzed its association with clinical, emotional, and functional variables. Forty-five FMS patients and 31 healthy individuals completed the Toronto Alexithymia Scale, which includes the dimensions: Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally-Oriented Thinking (EOT). Participants also completed instruments assessing Eysenck's personality dimensions, pain, fatigue, sleep, anxiety, depression, health-related quality of life (HRQL) and coping with pain. FMS patients exhibited higher scores in DIF and DDF than healthy individuals; group differences were markedly lower when depression and anxiety were statistically controlled. Patients furthermore displayed greater depression-anxiety, fatigue, sleep problems and neuroticism, lower HRQL and dysfunctional coping. Alexithymia was overall more closely related to clinical variables in healthy individuals than in patients; in patients, many associations disappeared when anxiety and depression were controlled. The data corroborate the high prevalence of alexithymia in FMS; however, they also suggest that alexithymia may play a less important role in symptom experience in patients vs. healthy individuals. This result may be discussed by considering the distinction between state and trait alexithymia; the weaker associations in patients may be ascribed to specific enhancement of state alexithymia due to illness-related affective distress.