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Alexithymia Linked With Reduced QOL, Increased Caregiver Burden in Parkinson Disease


Health-related quality of life and caregiver burden were both significantly correlated with alexithymia in patients with Parkinson disease, with the sub-component “identifying feelings” serving as a key factor.

Health-related quality of life (HR-QOL) and caregiver burden were both significantly correlated with alexithymia in patients with Parkinson disease (PD), with the sub-component “identifying feelings” serving as a key factor.

Over the past 2 decades, alexithymia has become identified as an additional nonmotor symptom in PD. Published in Brain Sciences, researchers explain that this multidimensional psychological construct is based on 4 distinct elements:

  • Difficulties in identifying and describing feelings
  • Difficulty in distinguishing between feelings and bodily sensations related to emotional activation
  • Restrained and limited imaginative processes, adopting the guise of an impoverished fantasy
  • A cognitive style oriented toward the outside

Patients with PD (PwP) are notable at-risk populations for alexithymia, with 18% to 23% of PwP meeting the condition’s diagnostic criteria, a figure nearly 2 times greater than the general population. Moreover, those who experience symptoms have been associated with lower satisfaction in life and are more likely to commit suicide.

Researchers noted that the impact of alexithymia on QOL of PwP is poorly understood, with no available data on the effect on caregivers. They examined disease-specific questionnaires to investigate these associations, with 119 PwP and their corresponding caregivers participating in the study.

Participants provided general background information, such as PwP’ disease duration and dedicated time giving care to the patient by caregivers. Caregivers’ HR-QOL was measured by the generic HR-QOL questionnaire short form 36 health survey and PwP HR-QOL was assessed by the Parkinson disease questionnaire 8, with 0 being the worst HR-QOL score and 100 being the best.

PwP further completed the Movement Disorders Society unified Parkinson’s disease rating scale (MDS-UPDRS) part II to evaluate their impairment of daily living, and were examined for alexithymia by the Toronto Alexithymia Scale with 26 items.

After conducting the analyses, HR-QOL of the PwP was found to correlate significantly with alexithymia (P < .001), especially in the sub-components “identifying feelings” (P < .001) and “difficulties describing feelings” (P = .001). Caregiver burden also exhibited a significant correlation with PwP alexithymia (P < .001), with most prominent associations occurring within sub-components “identifying feelings” (P < .008) and “external oriented thinking” (P < .004).

Researchers highlight that these correlations warrant more robust evaluation in assessing the impact of alexithymia due to possible confounders. “Interventions to decrease alexithymia in PwP are needed. These treatments might include psychotherapy and mindfulness-based interventions,” concluded the study authors.


Klietz M, Schnur T, Drexel SC, et al. Alexithymia is associated with reduced quality of life and increased caregiver burden in Parkinson disease. Brain Sci. Published online June 24, 2020. doi:10.3390/brainsci10060401

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