ALEXITHYMIA MAY INFLUENCE THE DIAGNOSIS OF CORONARY HEART-DISEASE

A number of psychosomatic studies have suggested that alexithymia, imp airment in identifying and expressing inner feelings, might somehow af fect the course of various illnesses. However, none of these studies h ave distinguished between an impact of alexithymia on actual pathophys iological change versus an impact only on illness behavior. In the pre sent study, a population-based random sample of 2297 middle-aged men f rom Eastern Finland was evaluated for alexithymia using the Finnish ve rsion of the self-report Toronto Alexithymia Scale (TAS). Although hig h TAS scores were associated with prior diagnosis of coronary heart di sease (CHD), they were not associated with greater prevalence of ische mia on an exercise tolerance test. The results of B-mode ultrasonograp hy of the carotid artery for those who had a CHD diagnosis showed that carotid atherosclerosis actually decreased significantly as alexithym ia increased. An interaction analysis indicated that alexithymia was r elated to increased probability of being diagnosed with CHD only among those who had mildly or moderately progressed carotid atherosclerosis , and not among those with the most severe progression. Alexithymia wa s associated with higher perceived exertion, and to some extent, with more self-reported symptoms during the exercise tolerance test. The fi ndings support the hypothesis that alexithymia relates to increased sy mptom reporting rather than pathophysiological changes in CHD. The res ults also suggest that alexithymic men may get diagnosed earlier, perh aps because of their different illness behavior.