Alexithymia is associated with insomnia in Chinese patients with schizophrenia

Fangfang Cai; Huixia Jiang; Siyu Tong; Siyao Zhou; Mengpu Wang; Shiyu Sun; Jie Liu; Yao Xu; Nankai Lin; Jiajing Dai; Xinyao Wang; Wei Wang; Ke Zhao; Xixi Wu

doi:10.3389/fpsyt.2023.1252763

Alexithymia is associated with insomnia in Chinese patients with schizophrenia

Front Psychiatry. 2023 Dec 15:14:1252763. doi: 10.3389/fpsyt.2023.1252763. eCollection 2023.

Authors

Fangfang Cai^#¹, Huixia Jiang^#¹, Siyu Tong^#¹, Siyao Zhou¹, Mengpu Wang¹, Shiyu Sun¹, Jie Liu¹, Yao Xu¹, Nankai Lin¹, Jiajing Dai¹, Xinyao Wang², Wei Wang^{1

3}, Ke Zhao^{4

5}, Xixi Wu⁶

Affiliations

¹ School of Mental Health, Wenzhou Medical University, Wenzhou, China.
² Renji College of Wenzhou Medical University, Wenzhou, China.
³ The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
⁴ Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China.
⁵ The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China.
⁶ Wenzhou Lucheng District Third People's Hospital, Wenzhou, China.

^# Contributed equally.

Abstract

Background: Sleep disorders are prevalent among patients with schizophrenia and are associated with several negative consequences. Although, researchers have recently suggested that sleep disorders have a close correlation with alexithymia, and schizophrenia also has a strong correlation with alexithymia, there have been few studies on the relationships between schizophrenia, sleep disorders and alexithymia. Therefore, this study aimed to explore the relationships between psychiatric symptoms, alexithymia and sleep problems in patients with schizophrenia so as to provide a reference for the clinical treatment of this comorbidity.

Methods: In total, 977 patients with schizophrenia were recruited for this study. The Insomnia Severity Index (ISI) was used to assess sleep disorders, and the Positive and Negative Syndrome Scale (PANSS), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Toronto Alexithymia Scale (TAS) were used to evaluate clinical symptoms, cognitive functions and the ability to express emotion, respectively.

Results: The results indicated that the PANSS subscales (G-subscore) and TAS group were risk factors for insomnia in schizophrenia patients (all p < 0.05). The mediation model showed the standardized path coefficients from schizophrenia to alexithymia (β = 0.104, p < 0.001) and from alexithymia to insomnia (β = 0.038, p < 0.001) were statistically significant.

Conclusion: The results of this study indicated that alexithymia is associated with sleep disturbance in patients with schizophrenia. These findings may provide a new avenue for the treatment of schizophrenia patients with sleep disorders.

Keywords: alexithymia; insomnia; negative symptom; recognition; schizophrenia.

Grants and funding

This work was supported by the Zhejiang Provincial Natural Science Foundation of China (No. LY22H090022) and Key Research and Development Project of Lishui Municipal (No.2023zdyf19).