Alexithymia impact on psychological outcomes in patients who had undergone cardiac surgery

Abstract

Background and aims: There is solid evidence that psychological factors are associated with cardiovascular diseases. However for cardiac surgery, reports on alexithymia and psychological outcomes are inconsistent. The aim of this study was to investigate alexithymia association with psychological factors in patients after cardiac surgery. Methods: This study involved 139 patients aged 28 to 75 years (94 men and 45 women) two months after cardiac surgery (coronary artery bypass graft or/and cardiac valve surgery). Psychological symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid ideation, psychotism and three distress aspects – global severity index, positive symptom total, positive symptom distress index) were assessed using Symptom Checklist - 90 Revised. The Mini International Neuropsychiatric Interview for the Diagnostic Statistical Manual IV criteria was used to identify mental disorders. Psychosomatic syndromes were evaluated according to the Interview for the Diagnostic Criteria for Psychosomatic Research. The 20-item Toronto Alexithymia Scale (TAS- 20) was used for the alexithymia assessment, its score ≥61 was evaluated as alexithymia. Results: 27% of patients (n=38) were assessed as being alexithymic. The most strong relations were found between TAS-20 score and depression (p=0.001) and positive symptom distress index (p<0.01). Also TAS-20 was associated with interpersonal-sensitivity, paranoid ideation, psychotism, global severity index and positive symptom total scales scores (p<0.05). Occurences of mental disorders or psychosomatic syndromes were not associated with alexithymia. Conclusion: Two months after cardiac surgery alexithymia was related to psychological outcomes – depression, distress, interpersonal-sensitivity, paranoidide-term children, and it could lead to higher myopia development.