L'expérience douloureuse et l'alexithymie dans la fibromyalgie.
(2009) Louvain médical — Vol. 128, n° 10, p. 369-374 (2009)
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- Abstract
- Objectives : The literature makes state of more somatic complaints and alexithymia in somatoform patients or experiencing chronic pain. Some researches show that alexithymia is observed in fibromyalgic (FM) patients. For some authors, alexithymia is seen as a somatosensory amplification, playing a role in pain perception. Nevertheless, the link between fibromyalgia and alexithymia and the question of its influence on pain intensity still remain under debate. The relations between alexithymia, fibromyalgia and intensity of pain are investigated. Patients and methods: 75 women diagnosed as fibromyalgic by a rheumatologist, according to the American College of Rheumatology (ACR) criteria, and 75 women suffering from no serious or invalidating affection nor chronic pain answered the Toronto Alexithymia Scale (TAS-20). Only the FM ones provided a quantitative and subjective measure of pain, by putting a mark on an analogic scale ranging from 0 to 100 mm. For FM patients, the number of tender points measured by a rheumatologist, will be considered as a quantitative and more objective measure of pain. Results: The FM patients obtain a higher score at the TAS-20 than the control group subjects (t = 5.268, d1 = 148, p < 0.001). More specifically, they have more difficulties in identifying then emotions (t = 6.774, d1 = 148, p < 0.001) and in expressing them to others (t = 3.302, d1 = 148, p = 0.001), but do not have a more inert cognitive style than the control group. The two measures of pain intensity, the subjective evaluation using an analogic scale and the number of tender points measured by a rheumatologist, are not correlated with the total score of alexithymia: alexithymic fibromyalgic patients do not have more tender points and do not rate pain as more intense than non-alexithymic fibromyalgic patients. Conclusions: According to the literature, the FM patients show alexithymic characteristics: they have more difficulties in identifying their emotions and in expressing them to others. Nevertheless, we can not affirm that alexithymia influences the intensity of pain. The prevalence of alexithymia in fibromyalgia lead us to discuss the presence of alexithymia before the onset of fibromyalgia, distinguishing between primary and secondary alexithymia. The former can be seen as a predisposing factor, making the subject more vulnerable to somatic and mental illnesses. Alexithymia could precipitate the onset of fibromyalgia but is not the only cause in such a multifactorial context, as we have seen. The latter is the consequence of psychological defense mechanisms, a coping strategy to a painful state, since pain generates a harmful emotional stress. A longitudinal study could provide evidence and help to choose, if possible, between the cause or consequence explanation.
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Asueta-Lorente, J.-F., Fohn, A., Tordeurs, D., Reynaert, C., & Léon, M. (2009). L’expérience douloureuse et l’alexithymie dans la fibromyalgie. Louvain médical, 128(10), 369-374. https://hdl.handle.net/2078.5/71573 (Original work published 2009)