Prevalence of alexithymia and its association with anxiety and depression in a sample of Greek chronic obstructive pulmonary disease (COPD) outpatients.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a major health problem, especially in adults over 40 years of age, and has a great social and economic impact. The psychological morbidity of COPD patients with regard to anxiety and depressive symptoms has been extensively studied in the past. However, few studies have investigated the prevalence of alexithymia in these patients, as well as its association with this comorbidity. Based on this fact, we studied the prevalence of alexithymia and its association with anxiety and depressive symptoms in COPD outpatients.


METHODS
The present study included 167, randomly selected, outpatients diagnosed with COPD. Alexithymia, anxiety and depression were assessed using the Toronto Alexithymia Scale (TAS-20), Spielberger Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively.


RESULTS
The mean BDI score was 12.88 (SD: 7.7), mean STAI score 41.8 (SD: 11.0) and mean TAS-20 score 48.2 (SD: 11.5). No differences were observed between genders regarding age and alexithymia (t test P > 0.05), while female patients presented higher depression and trait anxiety scores than males (t test P < 0.05). Clinically significant levels of anxiety were present in 37.1% of men, and in 45.7% of women. The mean depression score was also higher than the corresponding mean score in the general population (one-sample t test P < 0.01), while 27.7% and 30.5% of the sample presented mild and moderate to severe depression, respectively. Finally, a strong correlation was observed between alexithymia, depression and anxiety.


CONCLUSIONS
This study confirms the high prevalence of anxiety and depression symptoms in Greek outpatients with COPD. The prevalence of alexithymia in COPD patients, contrary to what has been observed in patients with other chronic respiratory diseases, seem to be lower. However, we observed a strong association between alexithymia, depression and anxiety levels. This observation suggests that alexithymia should be taken into consideration when drafting specific psychotherapeutic interventions for these patients.
Tselebis
Athanasios
A
Psychiatric Department, Sotiria General Hospital of Chest Diseases, Athens, Greece. atselebis@yahoo.gr
Kosmas
Epaminondas
E
Bratis
Dionisios
D
Moussas
Georgios
G
Karkanias
Athanasios
A
Ilias
Ioannis
I
Siafakas
Nikolaos
N
Vgontzas
Alexandros
A
Tzanakis
Nikolaos
N
Chest. 2008 Oct;134(4 Suppl):43S-56S
18842932
Psychother Psychosom. 1987;47(2):95-100
3449883
Chest. 2002 Nov;122(5):1633-7
12426264
Proc Am Thorac Soc. 2007 Oct 1;4(7):502-6
17878461
Int J Geriatr Psychiatry. 2001 Jul;16(7):690-3
11466747
J Psychosom Res. 1994 Jan;38(1):33-40
8126688
Eur Respir J. 2008 Mar;31(3):667-77
18310400
Respir Med. 2006 Jan;100(1):87-93
15893921
Arch Gen Psychiatry. 1994 May;51(5):355-64
8179459
Nurs Health Sci. 2001 Jun;3(2):69-71
11882180
Intern Med. 1996 Jun;35(6):453-8
8835595
J Psychosom Res. 2000 Jan;48(1):99-104
10750635
Psychosomatics. 2000 Nov-Dec;41(6):465-71
11110109
J Psychosom Res. 2006 Nov;61(5):629-35
17084140
J Psychosom Res. 2005 Dec;59(6):429-43
16310027
Respir Med. 2006 Oct;100(10):1767-74
16531031
Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55
17507545
Hum Resour Health. 2009 Aug 11;7:72
19671188
Am J Psychiatry. 1990 Feb;147(2):200-1
2301659
Med J Aust. 1987 Mar 16;146(6):305-7
3821636
Eur Respir J. 2006 Aug;28(2):296-302
16571616
Chest. 2007 Jul;132(1):148-55
17505033
BMC Pulm Med. 2009 Jan 02;9:2
19121205
Psychiatry Investig. 2009 Mar;6(1):13-8
20046368
Psychosomatics. 2001 May-Jun;42(3):229-34
11351111
Int J Geriatr Psychiatry. 2000 Dec;15(12):1090-6
11180464
Chest. 2004 Mar;125(3):892-900
15006947
Eur Respir J. 2005 Aug;26(2):242-8
16055871
Am J Psychiatry. 1991 Nov;148(11):1583-5
1928478
Psychother Psychosom. 1999 Sep-Oct;68(5):270-5
10516532
Braz J Med Biol Res. 2007 Jul;40(7):887-95
17653440
Psychol Rep. 2006 Aug;99(1):93-6
17037454
Chest. 1985 Jan;87(1):35-8
3965263
Psychother Psychosom. 1985;43(2):77-89
3983349
J Behav Med. 1983 Dec;6(4):339-57
6668602
J Cardiopulm Rehabil. 1999 Nov-Dec;19(6):362-5
10609186
Respir Res. 2009 Jan 09;10:1
19134192
Fam Pract. 2007 Jun;24(3):217-23
17504776
Ann Gen Psychiatry. 2008 May 21;7:7
18495038
Gen Hosp Psychiatry. 2001 Mar-Apr;23(2):56-61
11313071
Psychol Rep. 2003 Apr;92(2):529-32
12785636