Background: Alexithymia is one's incapacity to identify, comprehend, and describe emotions. There is almost no literature data about the levels of alexithymia among patients with relapse remitting type of multiple sclerosis.
Aim: The objective of the present study was to assess the levels of alexithymia in patients with relapse remitting type of multiple sclerosis in relation to their sociodemographic variables and clinical characteristics of the disease.
Methods: This cross-sectional study included 106 consecutively assessed patients with relapse remitting type of multiple sclerosis. In addition to the data regarding disease duration, number of demyelinating relapses, and degree of neurological disability, assessed by the expanded disability scale score (EDSS), we used Toronto alexithymia scale (TAS), fatigue severity scale (FSS) and, Hamilton scale for the assessment of anxiety and depression and sociodemographic questionnaire.
Results: Study included 74 female and 32 male patients, with a median age of 44 years, median disease duration 90 months, and median EDSS 4. About 29.55% of patients had alexithymia and borderline alexithymia was observed in 31.15% patients. Alexithymia correlated with anxiety and depression (P < 0.01) on all TAS subscales. Higher levels of neurological disability based on EDSS, severe fatigue based on FSS scores, and severe relapse remitting type of multiple sclerosis with more relapses and longer disease duration correlated with alexithymia (P < 0.01), depression (P < 0.01), and anxiety (P < 0.01). Higher rates of alexithymia were noticed in older, unemployed, single patients, and those having fewer children.
Conclusions: Alexithymia was found in a relatively high percentage in patients with relapse remitting type of multiple sclerosis.
Keywords: Alexithymia; anxiety; depression; multiple sclerosis.
Conflict of interest statement
High levels of alexithymia in patients with multiple sclerosis.Dement Neuropsychol. 2018 Apr-Jun;12(2):212-215. doi: 10.1590/1980-57642018dn12-020015. Dement Neuropsychol. 2018. PMID: 29988322 Free PMC article.
Fatigue during multiple sclerosis relapse and its relationship to depression and neurological disability.Psychiatr Danub. 2015 Dec;27(4):406-12. Psychiatr Danub. 2015. PMID: 26609654
Alexithymia in multiple sclerosis: relationship with fatigue and depression.Acta Neurol Scand. 2008 Jul;118(1):18-23. doi: 10.1111/j.1600-0404.2007.00969.x. Epub 2007 Dec 27. Acta Neurol Scand. 2008. PMID: 18162056
Mitoxantrone: a review of its use in multiple sclerosis.CNS Drugs. 2004;18(6):379-96. doi: 10.2165/00023210-200418060-00010. CNS Drugs. 2004. PMID: 15089110 Review.
The association between alexithymia as assessed by the 20-item Toronto Alexithymia Scale and depression: A meta-analysis.Psychiatry Res. 2015 May 30;227(1):1-9. doi: 10.1016/j.psychres.2015.02.006. Epub 2015 Feb 19. Psychiatry Res. 2015. PMID: 25769520 Review.
- Moghaddam VK, Sarmadi M, Tatari M, Najafi F, Esmaeili A, Hadei M. Epidemiology of multiple sclerosis in Torbat-e Heydarieh (Northeast of Iran) during 1982-2016. Mult Scler Relat Disord. 2018;24:184–9. - PubMed
- Howard J, Trevick S, Younger DS. Epidemiology of multiple sclerosis. Neurol Clin. 2016;34:919–39. - PubMed
- Inojosa H, Proschmann U, Akgün K, Ziemssen T. A focus on secondary progressive multiple sclerosis (SPMS): Challenges in diagnosis and definition. J Neurol. 2019 Jul 30; doi: 10.1007/s00415-019-09489-5. [Epub ahead of print] - PubMed
- Raimo S, Trojano L, Pappacena S, Alaia R, Spitaleri D, Grossi D, et al. Neuropsychological correlates of theory of mind deficits in patients with multiple sclerosis. Neuropsychology. 2017;31:811–21. - PubMed