Background Several evidences described a considerable prevalence of alexithymia among patients with chronic diseases, such as systemic autoimmune diseases. In patients affected by Systemic Lupus Erythematosus (SLE), alexithymia seems to be related to mood disorders and personality.
Objectives In this study we evaluated alexithymia in relation to HR-QoL (Health related Quality of Life) and to factor associated to HR-QoL, such as mood disorders, fatigue, work ability, sleep quality and physical activity.
Methods We consecutively enrolled SLE patients and healthy controls in a cross sectional study with a retrospective design. We wvaluated alexithymia by the Toronto Alexithymia Scale 20 (TAS-20). AHR-QoL was expressed by MOS-SF-36. Mood disorders was assessed by BDI and HAM-H. Fatigue was evaluated by Facit-Fatigue. Physical activity was quantified using International Physical Activity Questionnaire (IPAQ) and the sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Work ability was assessed by Work Productivity and Activity Impairment (WPAI). Cognitive impairment was defined according to MOCA screening test.
Results Fifty-two SLE patients and 50 age-matched healthy subjects were enrolled in the study. Mean TAS-20 score was significantly higher in SLE compared to controls (p<0.01). Alexithymic patients presented increased values of BDI score and HAM-H score (p<0.01 and p<0.05) and reduced Facit-Fatigue score (p<0.05). We found increased values of Work missed due to health problems and Activity impairment in alexithymic SLE subjects (p<0.05). SF-36 summary components PCS and MCS and SF-36 individual components did not significantly differ between alexithymic and non-alexithymic SLE. A greater proportion of alexithymic SLE patients presented fibromyalgia (p<0.05), low scholastic education (p<0.01), cognitive impairment according to MOCA test (p<0.01) and mild-to-severe depression according to BDI (p<0.01). We did not find differences among alexithymic and non alexithymic in MeS, obesity and physical inactivity prevalence. TAS-20 values positively correlated with BDI score (p<0.001), HAM-H score (p<0.01) and activity impairment score (p<0.01) and negatively with Facit-Fatigue score (p<0.01). In multiple linear regression, predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression according to BDI. In multiple logistic regression, alexithymia was significantly associated to BDI score (OR 1.2, 95% CI 1.0–1.4) and inversely associated to cognitive impairment (OR 0.1, 95% CI 0.02–0.8).
Conclusions SLE patients frequently present alexithymic tract. Alexithymia seems to be associated neither to disease feature, to disease course (activity and damage) and to SLE therapy, nor to HR-QoL expressed by SF-36. Nevertheless, alexithymia could be tightly related to QoL-associated factors as depression and fibromyalgia
Disclosure of Interest None declared