Vazquez Isabel, Sández Eva, González-Freire Beatriz, Romero-Frais Esther, Blanco-Aparicio Marina, Verea-Hernando Héctor
Facultad de Psicología, Psicología Clínica y Psicobiología, Campus Universitario Sur, Santiago de Compostela, Spain.
J Asthma. 2010 Sep;47(7):797-804. doi: 10.3109/02770900903560217.
Alexithymia is a personality trait characterized by difficulties in perceiving and expressing emotions. The relationship between alexithymia and health outcomes in asthma has been shown in a scarce number of studies, in which alexithymia has been considered as an homogeneous construct and the confounding potential effect of anxiety and depression has not been controlled for.
To determine the relationship between each of the three dimensions of alexithymia as assessed with the Twenty-Item Toronto Alexithymia Scale--Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking--and health-related quality of life and utilization of health care services, controlling anxiety and depression.
Patients with moderate to severe asthma between 18 and 65 years old filled in the Twenty-Item Toronto Alexithymia Scale, the Short-Form 36 Health Survey, the St. George's Respiratory Questionnaire, the Trait Anxiety Inventory, and the Cognitive Depression Index. Sociodemographic and clinical data were collected and the frequency of emergency room visits and hospitalizations due to asthma during the following 24 months was recorded. Data were analyzed using the ?2 test, the Mann-Whitney U test, Spearman correlations and multiple linear regression analyses.
A total of 76 patients took part in the study (42.67 ± 15.33 years; 59.2% female; 81.6% severe asthma). Data on emergency room visits during the 24-month follow-up were collected for 42 patients; 13 of them (30.95%) with at least one emergency room visit during the follow-up. After controlling for sociodemographic variables, clinical variables, anxiety, and depression, the Difficulty Describing Feelings factor was related to dimensions of the Short-Form 36 Health Survey: Physical Functioning (p = .021), Role-Physical (p = 0.025), and the Physical Component Score (p = .012). The Difficulty Identifying Feelings factor was associated with a higher frequency of emergency room visits (p = .005). The Externally Oriented Thinking factor was not related to any of the dependent measures.
Two dimensions of alexithymia, Difficulty Identifying Feelings and Difficulty Describing Feelings, are complicating factors in the management of asthma, but they operate via different mechanisms and over different outcomes and the effects of alexithymia remain even while controlling for the confounding effect of anxiety and depression.
述情障碍是一种人格特质，其特征是在感知和表达情感方面存在困难。在少数研究中已表明述情障碍与哮喘的健康结局之间的关系，在这些研究中，述情障碍被视为一个同质结构，并且焦虑和抑郁的潜在混杂效应未得到控制。
使用多伦多述情障碍20条目量表评估的述情障碍的三个维度——难以识别情感、难以描述情感和外向性思维——中的每一个与健康相关生活质量和医疗服务利用之间的关系，同时控制焦虑和抑郁。
18至65岁的中度至重度哮喘患者填写多伦多述情障碍20条目量表、简明健康调查问卷36项简短版、圣乔治呼吸问卷、特质焦虑量表和认知抑郁指数。收集社会人口学和临床数据，并记录接下来24个月内因哮喘急诊就诊和住院的频率。使用卡方检验、曼-惠特尼U检验、斯皮尔曼相关性分析和多元线性回归分析对数据进行分析。
共有76名患者参与研究（年龄42.67±15.33岁；59.2%为女性；81.6%为重度哮喘）。收集了42名患者在24个月随访期间的急诊就诊数据；其中13名患者（30.95%）在随访期间至少有一次急诊就诊。在控制了社会人口学变量、临床变量、焦虑和抑郁后，难以描述情感因子与简明健康调查问卷36项简短版的维度相关：身体功能（p = 0.021）、角色-身体（p = 0.025）和身体成分得分（p = 0.012）。难以识别情感因子与更高的急诊就诊频率相关（p = 0.005）。外向性思维因子与任何一项因变量均无关联。
述情障碍的两个维度，即难以识别情感和难以描述情感，是哮喘管理中的复杂因素，但它们通过不同的机制起作用且影响不同的结局，并且即使在控制了焦虑和抑郁的混杂效应后，述情障碍的影响仍然存在。
