title: Alexithymia is associated with greater risk of chronic pain and negative affect and with lower life satisfaction in a general population: the Hisayama Study.
abstract: BACKGROUND
  Chronic pain is a significant health problem worldwide, with a prevalence in the general population of approximately 40%. Alexithymia -- the personality trait of having difficulties with emotional awareness and self-regulation -- has been reported to contribute to an increased risk of several chronic diseases and health conditions, and limited research indicates a potential role for alexithymia in the development and maintenance of chronic pain. However, no study has yet examined the associations between alexithymia and chronic pain in the general population.
  
  
  METHODS
  We administered measures assessing alexithymia, pain, disability, anxiety, depression, and life satisfaction to 927 adults in Hisayama, Japan. We classified the participants into four groups (low-normal alexithymia, middle-normal alexithymia, high-normal alexithymia, and alexithymic) based on their responses to the alexithymia measure. We calculated the risk estimates for the criterion measures by a logistic regression analysis.
  
  
  RESULTS
  Controlling for demographic variables, the odds ratio (OR) for having chronic pain was significantly higher in the high-normal (OR: 1.49, 95% CI: 1.07-2.09) and alexithymic groups (OR: 2.56, 95% CI: 1.47-4.45) compared to the low-normal group. Approximately 40% of the participants belonged to these two high-risk groups. In the subanalyses of the 439 participants with chronic pain, the levels of pain intensity, disability, depression, and anxiety were significantly increased and the degree of life satisfaction was decreased with elevating alexithymia categories.
  
  
  CONCLUSIONS
  The findings demonstrate that, in the general population, higher levels of alexithymia are associated with a higher risk of having chronic pain. The early identification and treatment of alexithymia and negative affect may be beneficial in preventing chronic pain and reducing the clinical and economic burdens of chronic pain. Further research is needed to determine if this association is due to a causal effect of alexithymia on the prevalence and severity of chronic pain.
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan; Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Shibata
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Anno
authors.affiliation: Biostatistics Center, Kurume University, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Makino
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Iwaki
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamashiro
authors.affiliation: Department of Speech and Hearing Sciences, International University of Health and Welfare, School of Health Sciences at Fukuoka, Fukuoka, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Imada
authors.affiliation: Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kubo
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sudo
authors.affiliation: Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Hosoi
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012306:Risk; D055815:Young Adult