Alexithymia is associated with greater risk of chronic pain and negative affect and with lower life satisfaction in a general population: the Hisayama Study

Mao Shibata; Toshiharu Ninomiya; Mark P Jensen; Kozo Anno; Koji Yonemoto; Seiko Makino; Rie Iwaki; Koji Yamashiro; Toshiyuki Yoshida; Yuko Imada; Chiharu Kubo; Yutaka Kiyohara; Nobuyuki Sudo; Masako Hosoi

doi:10.1371/journal.pone.0090984

Alexithymia is associated with greater risk of chronic pain and negative affect and with lower life satisfaction in a general population: the Hisayama Study

PLoS One. 2014 Mar 12;9(3):e90984. doi: 10.1371/journal.pone.0090984. eCollection 2014.

Authors

Mao Shibata¹, Toshiharu Ninomiya², Mark P Jensen³, Kozo Anno⁴, Koji Yonemoto⁵, Seiko Makino⁴, Rie Iwaki⁴, Koji Yamashiro⁴, Toshiyuki Yoshida⁶, Yuko Imada⁴, Chiharu Kubo⁷, Yutaka Kiyohara⁸, Nobuyuki Sudo⁹, Masako Hosoi⁷

Affiliations

¹ 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.
² 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.
³ Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America.
⁴ Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁵ Biostatistics Center, Kurume University, Fukuoka, Japan.
⁶ Department of Speech and Hearing Sciences, International University of Health and Welfare, School of Health Sciences at Fukuoka, Fukuoka, Japan.
⁷ Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
⁸ Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁹ Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.

Abstract

Introduction: 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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Affective Symptoms / epidemiology*
Aged
Aged, 80 and over
Chronic Pain / epidemiology
Chronic Pain / psychology*
Depression / epidemiology
Female
Humans
Japan / epidemiology
Male
Middle Aged
Personal Satisfaction*
Risk
Young Adult

Grants and funding

MH was supported in part by Grants-in-Aid for Scientific Research C (number 21590766) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan; and for the Health and Labor Sciences Research from the Ministry of Health, Labor and Welfare of Japan (H23-Pain-Shitei-005). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.