Head injury and alexithymia: implications for family practice care

Background: Alexithymia, a deficit in emotional information processing, and a history of head injury have both been found to be related to high rates of psychosomatic illness, substance abuse, depression, and utilization of p rimary care services. To date, no study has examined the potential comorbid ity of alexithymia and head injury in a family practice setting, a necessar y step in evaluating the aetiologic role of head injury in the development of alexithymia. The goals of this study are to establish prevalence of head injury and alexithymia in a family practice setting and to evaluate the re lation, if present, between the two. Methods: Patients (n = 135) of a family practice residency facility were sc reened using the Traumatic Brain Injury Questionnaire and the Toronto Alexi thymia Scale-20. Results: Forty-nine per cent of the participants reported a history of head injury and 18% were alexithymic. Those with a history of head injury had s ignificantly higher scores of alexithymia. Chi-square analysis indicated a relation between head injury and alexithymia. Conclusions: The high rates of self-reported history of head injury in fami ly practice settings, particularly in the context of alexithymia, may adver sely affect a physician's ability to care for these patients. Increasing ph ysicians' awareness of head injury and the potential mediating role of alex ithymia in medical and psychological illness may facilitate effective diagn osis and patient-physician communication.