Kauhanen J, Kaplan G A, Cohen R D, Salonen R, Salonen J T
State of California Department of Health Services, Berkeley.
Psychosom Med. 1994 May-Jun;56(3):237-44. doi: 10.1097/00006842-199405000-00010.
A number of psychosomatic studies have suggested that alexithymia, impairment in identifying and expressing inner feelings, might somehow affect the course of various illnesses. However, none of these studies have distinguished between an impact of alexithymia on actual pathophysiological change versus an impact only on illness behavior. In the present study, a population-based random sample of 2297 middle-aged men from Eastern Finland was evaluated for alexithymia using the Finnish version of the self-report Toronto Alexithymia Scale (TAS). Although high TAS scores were associated with prior diagnosis of coronary heart disease (CHD), they were not associated with greater prevalence of ischemia on an exercise tolerance test. The results of B-mode ultrasonography of the carotid artery for those who had a CHD diagnosis showed that carotid atherosclerosis actually decreased significantly as alexithymia increased. An interaction analysis indicated that alexithymia was related to increased probability of being diagnosed with CHD only among those who had mildly or moderately progressed carotid atherosclerosis, and not among those with the most severe progression. Alexithymia was associated with higher perceived exertion, and to some extent, with more self-reported symptoms during the exercise tolerance test. The findings support the hypothesis that alexithymia relates to increased symptom reporting rather than pathophysiological changes in CHD. The results also suggest that alexithymic men may get diagnosed earlier, perhaps because of their different illness behavior.
多项心身研究表明，述情障碍，即识别和表达内心感受的障碍，可能会以某种方式影响各种疾病的病程。然而，这些研究均未区分述情障碍对实际病理生理变化的影响与仅对疾病行为的影响。在本研究中，使用芬兰语版的自我报告型多伦多述情障碍量表（TAS）对来自芬兰东部的2297名中年男性进行了基于人群的随机抽样，以评估述情障碍情况。尽管TAS高分与冠心病（CHD）的既往诊断相关，但在运动耐量测试中，它们与更高的缺血患病率无关。对患有冠心病的受试者进行颈动脉B超检查的结果显示，随着述情障碍程度的增加，颈动脉粥样硬化实际上显著减轻。交互分析表明，述情障碍仅在那些颈动脉粥样硬化轻度或中度进展的受试者中与被诊断为冠心病的可能性增加有关，而在那些进展最严重的受试者中则不然。述情障碍与更高的主观用力感相关，并且在一定程度上与运动耐量测试期间更多的自我报告症状相关。这些发现支持了述情障碍与冠心病中症状报告增加而非病理生理变化相关的假设。结果还表明，患有述情障碍的男性可能更早被诊断出来，这可能是因为他们不同的疾病行为。
