title: Alexithymia in oncologic disease: association with cancer invasion and hemoglobin levels.
abstract: BACKGROUND
  The literature suggests that alexithymia is the result of individual differences and/or biological mechanisms. Both individual differences and disease mechanisms may play a role among individuals with medical or surgical conditions. The relative weight of clinical and individual differences factors related to alexithymia has not been studied in patients with cancer. The purpose of this study was to examine the extent to which individual differences in perceived stress and biological markers of illness severity are associated with alexithymia among patients with cancer.
  
  
  METHODS
  Treated oncologic outpatients (N = 37) were assessed using the 20-item Toronto Alexithymia Scale and Perceived Stress Scale. Alexithymia was examined in relation to perceived stress, tumor staging, and hemoglobin levels.
  
  
  RESULTS
  Among the patients studied, 34.2% endorsed the established cutoff score (≥61) for alexithymia. Higher alexithymia scores were found in patients with more advanced stages of cancer invasion. Alexithymia correlated directly with perceived stress and indirectly with hemoglobin levels. Hemoglobin levels and cancer invasion significantly correlated with alexithymia when controlling for perceived stress.
  
  
  CONCLUSIONS
  A significant component of alexithymia in cancer patients may be construed as acquired. But awareness of health status influencing perceived stress might partially mediate the role of cancer invasion and hemoglobin on alexithymia.
authors.affiliation: Scuola di Specializzazione in Psichiatria, Università di Catania, Catania, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Messina
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Fogliani
authors.forename: Sergio
authors.initials: S
authors.lastname: Paradiso
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology* / Q000523:psychology*; D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D007206:Individuality; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications