Prevalence and correlates of alexithymia in older persons with medically (un)explained physical symptoms, 2022, Bos et al

Abstract

Objectives
Much is unknown about the combination of Medically Unexplained Symptoms (MUS) and alexithymia in later life, but it may culminate in a high disease burden for older patients. In the present study we assess the prevalence of alexithymia in older patients with either MUS or Medically Explained Symptoms (MES) and we explore physical, psychological and social correlates of alexithymia.

Methods and Design
A case control study was performed. We recruited older persons (>60 years) with MUS (N = 118) or MES (N = 154) from the general public, general practitioner clinics and hospitals. Alexithymia was measured by the 20-item Toronto Alexithymia Scale, correlates were measured by various questionnaires.

Results
Prevalence and severity of alexithymia were higher among older persons with MUS compared to MES. Alexithymia prevalence in the MUS subgroup was 23.7%. We found no association between alexithymia and increasing age. Alexithymia was associated with depressive symptoms, especially in the MUS population.

Conclusions
Alexithymia prevalence was lower than generally found in younger patients with somatoform disorder, but comparable to studies with similar diagnostic methods for MUS. Considering the high prevalence and presumed etiological impact of alexithymia in older patients with MUS, as well as its association with depression, this stresses the need to develop better understanding of the associations between alexithymia, MUS and depression in later life.

Open access, https://onlinelibrary.wiley.com/doi/10.1002/gps.5736

 

Whoever created that questionnaire, @Trish , would probably make an excellent prosecuting lawyer. They'll tie you in knots and then it will end up with you admitting to a murder you didn't commit.

The sub-text is not exactly hidden is it?

 

What would those be? There is nothing known about the biology of symptoms, all there is is association: this symptom is associated with this diagnosis or disease process. That's not an explanation. It's completely arbitrary, especially since it depends on perception of the disease, so that symptoms of cancer will be considered explained, while the same symptoms in ME will be dismissed, not because the symptoms themselves are explained, but based entirely on the recognition and perception of the diagnosis in medicine.

The conclusion is ridiculous. This is not a serious field of study.

 

As to statement number 3 in Trish's post:

"I have physical sensations even my doctors don't understand."

Yes, right up until Covid. Now that many people have experienced long-covid -- surprise -- much understanding has ensued.

These MUS that had in the past been systematically reframed as health anxiety so as to easily be ignored now turn out to be a real physical health issue as understood by the many health care practitioner's who now suffer these symptoms.

And still the band plays on for the MUS/BPS cabal. They are deeply invested in there alternative reality and can't let go. I think that's a mental health issue.

 

About alexithymia :

" The concept itself is debated and does not appear in international nosographic classifications." https://fr.wikipedia.org/wiki/Alexithymie

Thus, alexithymia isn't even in the DSM-5, the bible of psychiatrists. It is one of many concepts from psychoanalysis and psychosomatic theory. Here is its origin and on what basis it has been developed :

" Dr Sifneos’s * interest in psychosomatic medicine started early in his career when treating patients with so called psychosomatic illness. He observed that they often had an inability to find the appropriate words to describe their feelings. He discussed this at length with Dr John Nemiah, a close friend, who affirmed the observation. As a result, in 1972 Dr Sifneos introduced the term alexithymia from the Greek a for lack, lexis for word, and thymos for emotion, meaning lack of words for emotions. The term described a marked difficulty in experiencing, identifying, differentiating and expressing feelings; as well as a paucity of fantasies and a utilitarian (stimulus bound and tied to reality) way of thinking."
https://news.harvard.edu/gazette/story/2010/05/peter-emanuel-sifneos/

Thereby, the study authors of this thread wrote :

We know that's what they (authors) tend to think (irrepressible desire, perhaps ?), unfortunately for them, 76.3% of MUS patients did not have alexithymia according to their study !


* Peter Emanuel Sifneos, M.D. Professor Emeritus of Psychiatry at Harvard Medical School

* John Case Nemiah, Professor Emeritus of Psychiatry at both Harvard Medical School and Dartmouth Medical School