Alexithymia Construct in Dialysis Patients

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Introduction. The concept of alexithymia means dysfunction in emotional awareness, social attachment, and interpersonal relating. The study was performed to evaluate the alexithymia construct in patients treated with chronic maintenance haemodialysis.

Methods. TAS-20 was applied as a measure of alexithymia to a group of 230 patients, mean age 55.5±13.5 years, recruited from three dialysis centers.

Results. The results obtained showed that 50% of patients were alexithymic, and 18% had possible alexithy-mia. A small positive correlation was shown between age and obtained scores for alexithymia (r=0.025). Duration of dialysis also positively influenced the alexithymia scores (r=0.013). In addition, the duration of dialysis was significantly influenced by age (ANOVA 0.004, p<0.05). Factors analysis showed that F1 and F2 were not influenced by age or duration of dialysis. Only factor F3 (externally oriented thinking) was very perceptible and influenced by the age and the duration of dialysis (ANOVA p=0.016; <0.05).

No significant differences in scores between males and females were obtained. Only F1 was higher in males (p<0.05). The scores obtained for alexithymia were compared between healthy population and cancer and dialysis patients. Patients with chronic diseases were more alexithymic than healthy people (p< 0.05).

Conclusions. The alexithymia construct is a permanent personality trait related to neurobiological brain specifics. An alexithymia construct can influence the prognosis and outcome of dialysis patients as well as of other diseases. The psychological support for mediating alexithy-mia should be included in the therapeutic protocols, especially for end-stage renal diseases.

1. Nemiah JC, Freyberger H, Sifneos PE. Alexithymia: a view of the psychosomatic process. In: Hill OW editor. Modern Trends in Psychosomatic Medicine. London: Butterworths 1976; 430-439.

2. Sifneos PE. Alexithymia: past and present. Am J Psychiatry 1996; 153(7 Suppl): 137-142.

3. Taylor GJ, Bagby RM, Parker JD. The alexithymia construct. A potential paradigm for psychosomatic medicine. Psychoso-matics 1991; 32(2): 153-164.

4. Matilla AK, Kronholm E, Jula A, et al. Alexithymia and Somatization in General Population Psychosom Med 2008; 70: 716-722.

5. Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia Scale- I, Item selection and cross validation of the factor structure. J Psychosom Res 1994; 38: 23-33.

6. Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia Scale- II: Convergent, discriminant, and concurrent validity. J Psychosom Res 1994; 38: 31-41.

7. Taylor GJ, Bagby RM, Parker JD. The 20-Item Toronto Alexithymia Scale IV. Reliability and factorial validity in different languages and cultures. J Psychosom Res 2003, 55: 277-283.

8. Parker JDA, Bagby RM, Taylor GJ, et al. Factorial validity of the 20-item Toronto Alexithymia Scale. European J Pers 1993, 7: 221-232.

9. Haviland MG. The validity of the California Q-set alexithymia prototype. Psychosomatics 1998; 39: 536-539.

10. Hendryx MS, Haviland MG, Shaw DG. Dimensions of alexithymia and their relationships to anxiety and depression. J Pers Assess 1991; 56: 227-237.

11. Pop-Jordanova N, Polenakovic M. Psychological characteristics of patients treated by chronic maintenance haemodia-lysis. Int J Artif Organs 2013; 36: 77-86.

12. Pop-Jordanova N, Polenakovic M. Psychological problems among patients undergoing hemodialysis therapy. Prilozi 2012; 33(2): 117-129.

13. Pop-Jordanova N, Boskovska V. TAS-20 as a measure of alexithymia in Macedonian population. Neurol Croat 1995; 44(1): 60.

14. Pop-Jordanova N. Alexithymia and cancer. Jpn J Psycho-som Med 1997; 37: 585-588.

15. Cabras PL, Albanesi G, Calabresi M, Martinelli F. Chronic dialysis and forcing of the ability to fantasize. Evaluation of the alexithymic phenomenon in a group of dialyzed patients. Riv Patol Nerv Ment 1983; 104(5): 213-223.

16. Levenson JL, Glocheski S. Psychological factors affecting end-stage renal disease. A review. Psychosomatics 1991; 32(4): 382-389.

17. Wang LJ, Chen CK. The Psychological Impact of Haemodia-lysis on Patients with Chronic Renal Failure. In: Renal Failure-The Facts, In Tech 2012; 217-236.

18. Claxton RN, Blackhall L, Weisbord SD, Holley JL. Under-treatment of symptoms in patients on maintenance hemodia-lysis. J Pain Symptom Manage 2010; 39(2): 211-218.

19. Palmer S, Vechhio M, Craig J. et al. Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. Kidney Int 2013; 84: 179-191.

20. Jula A, Salminen JK, Saarijarvi S. Alexithymia, a Facet of Essential Hypertension, Hypertension 1999; 33: 1057-1061.

21. Kojima M. Epidemiologic studies of psychosocial factors associated with quality of life among patients with chronic diseases in Japan. J Epidemiol 2012; 22(1): 7-11.

22. Weisbord SD, Bossola M, Fried LF, et al. Cultural comparison of symptoms in patients on maintenance hemodialy-sis. Hemodial Int 2008; 12(4): 434-40.

23. Fukunishi I, Norris P, Fahrion S, et al. A comparison of alexithymia in American and Japanese dialysis patients Psychother Psychosom 1992; 57(1-2): 75-80.

24. De Santo RM, Livrea A, De Santo NG, et al. The high prevalence of alexithymia in hemodialyzed patients with secondary hyperparathyroidism unsuppressed by medical therapy is cured by parathyroidectomy. J Ren Nutr 2010; 20 (5 Suppl): S64-70.

25. Kojima M, Hayano J, Tokudome S, et al. Independent associations of alexithymia and social support with depression in hemodialysis patients. J Psychosom Res 2007; 63(4): 349-356.

26. Kojima M, Hayano J, Suzuki S, et al. Depression, alexithy-mia and long-term mortality in chronic hemodialysis patients. Psychother Psychosom 2010; 79(5): 303-311.

27. Fukunishi I. Psychosomatic aspects of patients on hemodia-lysis. The relationship between quality of life and alexithy-mia. Psychother Psychosom 1990; 54(4): 221-228.

28. Fukunishi I. Psychosomatic aspects of patients on hemodia-lysis. Clinical usefulness of alexithymia. Psychother Psychosom 1990; 54(4): 214-220.

29. Fukunishi I, Saito S, Ozaki S. The influence of defense mechanisms on secondary alexithymia in hemodialysis patients. Psychother Psychosom 1992; 57(1-2): 50-56.

30. Deng Y, Ma X, Tang Q. Brain response during visual emotional processing: an fMRI study of alexithymia. Psychiatry Res 2013; 213(3): 225-229.

31. Moriguchi Y, Gen Komaki G. Neuroimaging studies of alexithymia: physical, affective, and social perspectives Biopsychosoc Med 2013; 7(1):8.

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