The influence of alexithymia on disease activity and quality of life in patients with axial spondyloarthritis: A cross-sectional study

Objective: To evaluate the prevalence of alexithymia and its influence on disease activity, quality of life, and clinical outcomes in axial spondyloarthritis (axSpA) patients. Patients and Methods: This cross-sectional study included 110 (59 men and 51 women) consecutive axSpA patients who agreed to participate at our rheumatology outpatient clinic. Patient demographics, pain, disease activity measures, functionality, quality of life, alexithymia, psychological status, neuropathic pain, and fibromyalgia were evaluated. Patients were divided into 2 groups (without vs with alexithymia) and compared. The risk factors for alexithymia were evaluated. Results: The prevalence of alexithymia in axSpA patients was 31.8% according to a Toronto Alexithymia Scale--20 cutoff of =61. The mean age and body mass index of patients were 41.25 +/- 9.64 years and 27.73 +/- 4.51 kg/m2, respectively. Most patients with alexithymia were women. Patients with alexithymia had significantly high scores for depression, anxiety, fibromyalgia, disease activity, enthesitis, worse quality of life, and poor functionality (all P < 0.05). Female gender (odds ratio [OR] = 22.359), patient global assessment (OR = 7.873), Bath Ankylosing Spondylitis Functional Index (OR = 1.864), and fibromyalgia symptom severity (OR = 1.303) were found to be independent risk factors for alexithymia. Conclusion: The present study results showed that about one-third of axSpA patients had alexithymia, and the patients with alexithymia had higher disease activity, worse quality of life, and worse functional status than those without alexithymia. Female gender, patient global assessment, functional status, and fibromyalgia symptom severity were found to be important contributing factors to alexithymia.