The percentage and clinical correlates of alexithymia in stable patients with schizophrenia

Eur Arch Psychiatry Clin Neurosci. 2023 Apr;273(3):679-686. doi: 10.1007/s00406-022-01492-8. Epub 2022 Oct 14.

Abstract

Alexithymia is a common, but less-recognized affective deficit in patients with schizophrenia. To date, no definitive conclusions have been drawn about the relationship between alexithymia and the clinical symptoms or their clinical correlates, particularly in stable patients with schizophrenia. The purpose of this study was to investigate the link between alexithymia and psychopathological symptoms, as well as any associated correlates, in stable patients with schizophrenia. A total of 435 Chinese patients with schizophrenia were recruited. The Positive and Negative Symptoms Scale (PANSS) was used to evaluate each patient's psychopathological symptoms. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia. The percentage of alexithymia was 35.2% in stable patients with schizophrenia. Compared to non-alexithymia patients, patients with alexithymia had higher PANSS total scores, negative subscores, depressive subscores, and cognitive subscores (all p < 0.05). Multivariate regression analysis revealed that the following variables were positively associated with TAS-20 total scores: PANSS negative subscores (β = 0.274, t = 3.198, p = 0.001) and PANSS depressive subscores (β = 0.366, t = 2.500, p = 0.013). Education years (β = - 0.453, t = - 2.824, p = 0.005) was negatively associated with TAS-20 total scores. Our results suggest that the percentage of alexithymia was relatively higher in stable patients with schizophrenia. Education levels, negative symptoms, and depressive symptoms were independently associated with alexithymia in this specific population.

Keywords: Alexithymia; Depressive symptoms; Negative symptoms; Schizophrenia.

MeSH terms

  • Affective Symptoms* / epidemiology
  • Affective Symptoms* / etiology
  • East Asian People
  • Humans
  • Psychopathology
  • Schizophrenia* / complications
  • Schizophrenia* / diagnosis
  • Schizophrenia* / epidemiology