Type 1 diabetes is associated with alexithymia in nondepressed, non-mentally ill diabetic patients: A case-control study

• Published in: Journal of psychosomatic research 2009-10, Vol.67 (4), p.307-313
• Main Authors: Chatzi, Leda, Bitsios, Panos, Solidaki, Eleni, Christou, Irini, Kyrlaki, Evridiki, Sfakianaki, Maria, Kogevinas, Manolis, Kefalogiannis, Nikolaos, Pappas, Angelos
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Affective Symptoms - blood; Affective Symptoms - diagnosis; Affective Symptoms - psychology; Alexithymia; Biological and medical sciences; Case-control study; Coronary Disease - blood; Coronary Disease - psychology; Depression; Depression - blood; Depression - diagnosis; Depression - psychology; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - psychology; Diabetes. Impaired glucose tolerance; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - psychology; Diabetic Retinopathy - blood; Diabetic Retinopathy - psychology; Disease Progression; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glycated Hemoglobin A - analysis; Health Behavior; Humans; Male; Medical sciences; Middle Aged; Mood disorders; Personality Inventory; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Care - psychology; Type 1 diabetes; Type 1 diabetes mellitus
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2009.04.011

Abstract Objective Alexithymia refers to difficulty in identifying and expressing emotions, and it is a characteristic common to several psychiatric and medical conditions, including autoimmune disorders. Type 1 diabetes (T1D) is an autoimmune disorder with increased psychiatric comorbidity. Previously reported associations between alexithymia and T1D may have been confounded by the presence of depression. The central aim of this study was to examine alexithymia levels in psychiatrically uncomplicated T1D outpatients with that of nondiabetic controls. Methods Ninety-six T1D patients without any DSM-IV Axis I diagnoses and 105 age- and sex-matched healthy controls entered the study. Alexithymia and depressive symptoms were assessed with the Toronto Alexithymia Scale (TAS-20) and the Beck Depression Inventory (BDI-21), respectively. Multivariate regression models were used to evaluate the association of alexithymia with the presence of diabetes, duration of diabetes, diabetes control, parameters of treatment intensification, and diabetic complications. Results T1D was positively associated with the TAS-20 “identifying feelings” ( β coefficient=2.64, P =.003) and “externally oriented thinking” ( β coefficient=1.73, P =.011) subscales. The prevalence of overall alexithymia (TAS-20 total score, ≥60) was 22.2% in T1D patients and 7.6% in the controls (OR, 4.6; 95% CI, 1.7–12.8). TAS-20 scores were positively associated with diabetes duration and negatively with treatment intensification parameters. Conclusions Alexithymia is higher in psychiatrically uncomplicated T1D patients than in healthy controls even after adjustment for confounding depressive symptoms; it is greater with longer diabetes duration and is associated with some reduced parameters of treatment intensification but not with worse outcome in terms of glycemic control or somatic complications.