title: Alexithymia, anxiety and depression in patients with psoriasis: a case-control study.
abstract: BACKGROUND
  Alexithymia, the difficulty in describing or recognizing emotions, has been associated with various psychosomatic pathologies including psoriasis. The aim of this study was to examine the prevalence of alexithymia and its association with anxiety and depression in patients with psoriasis compared with healthy participants, while taking into consideration demographic and clinical variables.
  
  
  METHODS
  One hundred and eight psoriatic patients and 100 healthy participants from the general population completed the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS). The severity of patients' psoriasis was clinically assessed using the Psoriasis Area and Severity Index (PASI).
  
  
  RESULTS
  Psoriatic patients had higher levels of alexithymia compared with healthy participants. While a rather high rate of psoriatic patients presented anxiety and depression as defined by the HADS, the differences that were found in comparison with the control group were not significant. Neither alexithymia nor its dimensions, difficulty in identifying feelings (DIF), difficulty in describing feelings (DDF) and externally oriented thinking (EOT), were associated with gender or psoriasis severity. Age was associated only with EOT, which was independent of depression and anxiety. Higher anxiety and depression were connected with higher alexithymia and DIF, while higher anxiety with higher DDF as well.
  
  
  CONCLUSIONS
  The alexithymia prevalence was higher in psoriatic patients than that in healthy participants, while it was positively correlated with anxiety and depression. Difficulty in identifying feelings was connected with both anxiety and depression, whereas difficulty in describing them was only with anxiety. Finally, externally oriented thinking was predicted only from age.
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Korkoliakou
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Christodoulou
authors.affiliation: Second Department of Dermatology, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Anargyros
authors.initials: A
authors.lastname: Kouris
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Evgenia
authors.initials: E
authors.lastname: Porichi
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Efstathiou
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Eythymia
authors.initials: E
authors.lastname: Kaloudi
authors.affiliation: University Mental Health Research Institute (UMHRI), Athens, 15601 Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Kokkevi
authors.affiliation: Second Department of Dermatology, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Stavrianeas
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece ; University Mental Health Research Institute (UMHRI), Athens, 15601 Greece.
authors.forename: Charalabos
authors.initials: C
authors.lastname: Papageorgiou
authors.affiliation: Second Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, Athens, 12462 Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Douzenis
keywords: Alexithymia; Anxiety; Depression; Psoriasis; TAS-20