Alexithymia and depression in the recovery of chronic pain patients: a follow-up study
Sammanfattning
Background: Childhood adversities and emotional dysregulation are connected with chronic pain,
alexithymia, and depression. Longitudinal studies exploring the impact of their co-occurrence on the
pain situation are rare.
Aims: The influence of alexithymia, depression, baseline pain situation, and treatment options on the
course of chronic pain in a clinical sample was studied.
Methods: The baseline data was collected from chronic pain patients (n ¼ 154) before their first pain
clinic visit, and the follow-up data after 1 year by self-report questionnaires. Study variables consisted
of pain intensity, pain disability, alexithymia (TAS-20), depression (BDI-II), and treatment interventions.
Statistical analyses were performed to find out differences between baseline and follow-up, as well as
between alexithymic and non-alexithymic patients, and to estimate the effect of the treatment
provided.
Results: At follow-up, the majority of the patients had pain intensity and disability severe enough to
disrupt with their daily living. None of treatment interventions was related to better outcome.
Alexithymic patients reported more pain disability and depression at both baseline and at follow-up.
The effect of alexithymia on pain disability was mediated by depression. The use of opioids was connected
to alexithymia and depressiveness. Alexithymia and depression made a substantial contribution
to poorer outcome.
Conclusions: Severe pain intensity and disability with depression and alexithymia predicted difficulties
in achieving improvement. Depression and alexithymia probably impair compliance with treatment
and adherence to interventions. Their co-occurrence with a more severe pain situation and with the
use of opioids indicates psychological problems underlying the pain experience.