Pitfalls in Respiratory Allergy Management: Alexithymia and Its Impact on Patient-Reported Outcomes

• Published in: The Journal of asthma Vol. 48; no. 1; pp. 25 - 32
• Main Authors: Baiardini, Ilaria, Braido, Fulvio, Ferraioli, Gianluca, Menoni, Stefania, Bruzzone, Marco, Conte, Maria Elisabetta, Gani, Federica, Ridolo, Erminia, Scordamaglia, Antonio, Canonica, Giorgio Walter
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-02-2011; Taylor & Francis
• Subjects: Adult; Affect; Affective Symptoms - complications; alexithymia; asthma; Asthma - physiopathology; Asthma - psychology; Asthma - therapy; Attitude to Health; Female; Humans; Male; Middle Aged; patient-reported outcomes; Quality of Life; rhinitis; Stress, Psychological; Treatment Outcome
• ISSN: 0277-0903; 1532-4303
• DOI: 10.3109/02770903.2010.535883

Objectives. Alexithymia is a personality trait characterized by a limited ability to identify and express emotions and it represents a possible risk factor for disease development and management. The objective of the study is to evaluate alexithymia in patients with persistent asthma and comorbid rhinitis and its relation with patient-reported outcomes (PROs). Methods. Alexithymia, quality of life, illness perception, and stress were assessed, as well as rhinitis symptoms and asthma control in out-patients classified according to GINA and ARIA guidelines. Results. Out of 115 patients, 19% turned out to be alexithymic (TAS-20 ≥ 61). Concerning alexithymia level, no difference was detected between males and females (χ2 = 0.317) and among GINA levels (χ2 = 0.22). Alexithymics had significantly lower Asthma Control Test scores when compared with non-alexithymics (15.86 vs. 19; p = .02). Alexithymics had a worse quality of life (p< .001) and, concerning illness perception, they ascribed to respiratory allergy symptoms that are not strictly disease related and referred to asthma and rhinitis more serious negative consequences (p < .001) and emotional representations (p < .035). Moreover, they had lower illness coherence (p < .001) and lived their disease as a cyclical rather than a chronic disorder (p < .035). As regards stress, alexithymics reported less energy (p < .001), higher levels of tension (p < .001), depression (p < .001), confusion (p > .001), and inertia (p < .001). Conclusion. Alexithymia is present in a relevant percentage of subjects and, as it can modulate illness perception, quality of life, and stress, it should be considered in disease management.