The role of alexithymia: An 8-year follow-up study of chronic pain patients |
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| Institution: | 1. Pain Clinic, Raahe Hospital, P.O. BOXs 25, 92101, Raahe, Finland;2. Pain Clinic, Oulu University Hospital, P.O. BOX 21, FIN-OUH, Oulu, Finland;3. Department of Psychiatry, Tampere University Hospital, P.O. BOXs 2000, 33521 Tampere, Finland;4. School of Health Sciences, Tampere University, 33014 Tampere, Finland;5. Unit of Adolescent Psychiatry, Satakunta, Hospital District, Antinkatu 15A, 28100 Pori, Finland;1. Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy;2. Mental Health Department, AUSL, Parma, Italy;1. Department of Orthopedics, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;2. Department of Orthopedics and Traumatology, University Hospital Graz, Medical University of Graz, Graz, Austria;3. Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, TX, USA;4. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;1. Department of Psychology, Wayne State University, Detroit, MI, USA;2. Department of Internal Medicine, St. John/Providence Health System, Southfield, MI, USA;1. University of Cyprus, Nicosia, Cyprus;2. Houston OCD Program, Houston, TX, USA;3. The Menninger Clinic Houston, TX, USA;4. McLean Hospital, Belmont, MA, USA |
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| Abstract: | ObjectiveThe aim of this 8-year follow-up study was to ascertain changes in alexithymia, depressiveness and pain situation in a sample of chronic pain patients and to explore the impact of alexithymia and depression on the outcome.MethodsParticipants (n = 83) were chronic non-malignant pain patients who completed self-report study questionnaires before their first visit to the pain clinic and again 8 years later. Study variables consisted of pain intensity measured by the Visual Analogous Scale, the Pain Disability Scale, the Toronto Alexithymia Scale and the Beck Depression Inventory. The moderate improvement in the pain situation was estimated as a decrease of 30% or more in pain intensity or pain disability.ResultsIn the whole sample there was a significant decrease in pain intensity, pain disability and depressiveness, but only some of the patients achieved moderate improvement in their pain situation. Alexithymia remained stable during the 8-year period. The alexithymic patients had poorer pain situation and more depressiveness both at baseline and at follow-up. Unfavorable outcome in the pain situation was connected with male gender and alexithymia at baseline but not with depressiveness. Alexithymia and depressiveness were closely related to each other and the connection strengthened during the follow-up period.ConclusionAlexithymic depressive chronic pain patients represent a special, more disabled subgroup among chronic pain patients. The authors recommend screening for and identifying alexithymia and depression in chronic pain patients. Structural treatment protocols such as cognitive–behavioral therapy may benefit these patients. More research is needed to develop treatment interventions for alexithymic patients. |
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