The Pain Clinic, Vol. 18, No. 1, pp. 1–9 (2006)  2006 VSP Also available online - www.vsppub.com Research paper Clinical correlates of alexithymia in patients with fibromyalgia BILGE EVREN 1 , CUNEYT EVREN 2,∗ and MINE HOSAFCI GULER 3 1 Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey 2 Bakirkoy State Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey 3 Physical Therapy and Rehabilitation Department, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey The aim of this study was to determine the prevalence of alexithymia and evaluate the relationship between alexithymia and psychiatric symptoms, severity of pain, depression and anxiety in Turkish female outpatients with fibromyalgia (FM). Fifty-one patients with FM according to the operational criteria proposed by the American College of Rheumatology were included in the study. These patients were measured for alexithymia, depression, anxiety, psychiatric symptoms and pain intensity. Twenty (39.2%) of the FM patients had 61 or higher scores on TAS-20 and were considered as alexithymic. We found positive correlations between TAS-20 and BDI, BAI, HDRS, HARS Psychic and HARS Somatic subscales and subscales of SCL-90, whereas there were no significant correlations between TAS-20 and VAS, VRS and HARS. Similar correlations were found for ‘difficulty in identifying feelings’ (DIF) and ‘difficulty in describing feelings’ (DDF) subscales of TAS-20. The ‘externally orientated thinking’ (EOT) subscale of TAS-20 was correlated only with BAI and HARS Somatic scales. Determinants were BDI, SCL-90 Symptom Index scores when total TAS score was taken as a dependent variable in linear regression. Alexithymia was related with current general psychiatric symptoms and severity of depression and anxiety, but not with severity of pain in FM patients. summary Key words: Alexithymia; anxiety; depression; fibromyalgia; psychiatric symptoms. Alexithymia is a personality construct characterized by difficulty in identi- introduction fying and communicating feelings, and externally oriented thinking 1 . The concept of alexithymia has been studied in a variety of medical, psychoso- matic and psychiatric disorders. Clinical studies showed that alexithymia can be seen in a variety of psychiatric and medical disorders 2 . Alexithymia was first thought to be a characteristic for psychosomatic dis- orders. Indeed there is clinical evidence indicating an association between alexithymia and somatization 3,4 . Fibromyalgia (FM) is a medically unex- plained pain syndrome, which is often viewed as a type of somatization 4 . It is a chronic musculoskeletal pain syndrome characterized by widespread musculoskeletal pain, multiple tender points, fatigue and sleep disturbances 5 . Elevations on psychological self-report measures assessing depression, anxi- ety and hypochondriasis, have been reported in FM patients as well as studies refuting these results 6 . Chronic pain patients have difficulty in identifying feelings, which in turn makes them prone to somatic expressions of psychic distress 7 . Some ∗ To whom correspondence should be addressed. E-mail: cuneytevren@hotmail.com; cuneytevren@yahoo.com