Anxiety and mood (대한불안의학회지)

Korean Academy of Anxiety Disorders (대한불안의학회)
권호 표지

불안 장애 환자와 우울 장애 환자의 감정표현불능증

  • Kim, Pu Yong (Department of Nursing, Dongsan Medical Center, Keimyung University) ;
  • Ryu, Seuk Hwan (Division of Sleep Clinic, Department of Neuropsychiatry, Soonchunhyang University Gumi Hospital)
  • 김부용 (계명대학교 동산의료원 간호과) ;
  • 류석환 (순천향대학교 의과대학 정신과학교실)
  • Received : 2015.09.08
  • Accepted : 2015.10.20
  • Published : 2015.10.30
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Abstract

Objective : The aim of the study was to investigate the difference in alexithymia between anxiety disorder and depressive disorder. The second was to evaluate the effect of alexithymia on quality of life in patients with anxiety disorder and depressive disorder. Methods : A total of 175 patients with diagnoses of anxiety disorder or depressive disorder were recruited. Demographic, psychosocial, and clinical data were analyzed, as well as results on the 20-item Toronto alexithymia Scale (TAS-20K), the Symptom Checklist-90-Re-vised (SCL-90-R), a quality of life scale, the Beck Depression scale, and Beck Anxiety Inventory. Results : As compared with the patients with anxiety disorder, patients with depressive disorder showed significantly higher total score on the TAS-20K and for factor 1 (difficulties identifying feelings) and factor 2 (difficulties describing feeling) scales of the TAS-20K and showed significantly lower scores of psychosocial well-being on the quality of life scale. Total scores on the TAS-20K correlated significantly with scores for some subscale on the quality of life scale. Conclusion : This study suggest that patients with depressive disorder had more alexithymic symptoms and worse quality of life compared with those with anxiety disorder. Also, alexithymic symptoms are found to be associated with quality of life. Therefore, clinicians should try to focus on relieving symptoms to help patients restore their psychological well-being and improve their quality of life.

Keywords

References

  1. Sifneos PE. The chosomatic patients. Psychother Psychosom 1973; 22:255-262. https://doi.org/10.1159/000286529
  2. Sifneos PE. Alexithymia; past and present. Am J Psychiatry 1996;153:137-142. https://doi.org/10.1176/ajp.153.7.137
  3. Haviland MG, Shaw DG, MacMurry JP, Cummings MA. Validation of the Toronto Alexithymia Scale with substance abusers. Psychother Psychosom 1988;50:81-87 https://doi.org/10.1159/000288104
  4. Taylor GJ, Parker JD. Bagby RM. A preliminary investigation of alexithymia in men with psychoactive substance dependence. Am J Psychiatry 1990;147: 1228-1230. https://doi.org/10.1176/ajp.147.9.1228
  5. Henry JP, Haviland MG, Cummings MA, Anderson DL. Nelson JC, MacMurray JP et al. Shared neuroendocrine patterns of posttraumatic stress disorder and alcxithymia. Psychosom Med 1992;54:407-415. https://doi.org/10.1097/00006842-199207000-00003
  6. Zeitlin SB, Mcnally RJ, Cassiday KL. Alexithymia in victims of sexual assaults; an effect of repeated traumatization? Am J Psychiatry 199;150:661-663. https://doi.org/10.1176/ajp.150.4.661
  7. de Groot JM, Rodin G, Olmsted MP. Alexithymia, depression, and treatment outcome in bulimia nervosa. Compr Psychiatry 1995;36:53-60. https://doi.org/10.1016/0010-440X(95)90099-H
  8. Cox BJ, Swinson RP, Shulman ID, Bourdeau D. Alexithymia in panic disorder and social phobia. Compr Psychiatry 1995;36:195-198. https://doi.org/10.1016/0010-440X(95)90081-6
  9. Parker JDA, Taylor GJ, Bagby RM, Acklin MW. Alexithymia in panic disorder and simple phobia; a comparative study. Am J Psychiatry 1993;150;1105-1107. https://doi.org/10.1176/ajp.150.7.1105
  10. Zeitlin SB, McNally RJ. Alexithymia and anxeity sensitivity in panic disorder and obsessive compulsive disorder. Am J Psychiatry 1993;150:658-660. https://doi.org/10.1176/ajp.150.4.658
  11. Wise TN, Jani NN, Kass E, Sonnenschein K, Mann LS. Alexithymia; relationship to severity of medical illness and depression. Psychother Psychosom 1988;50:68-71. https://doi.org/10.1159/000288102
  12. Ryu SH. Quality of life of Patients with depressive disorder receiving antidepressants: Relationship between quality of life and alexithymia. Korean J Psychopharmacol 2009;20:316-324.
  13. Cho MJ, Chans SM, Hahm BJ, Chung IW, Bae A, Lee YM, et al. Prevalence and correlates of major mental disorders among Korean adults a 2006 national epidemiologic survey. J Korean Neuropsychintr Assoc 2009;48:143-152.
  14. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendlcr KS. Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric disorders in the United States; Results from thc national comorbiditysurvey. Arch Gen Psychiatry 1994;51:8-19 https://doi.org/10.1001/archpsyc.1994.03950010008002
  15. Berthoz S, Consoli S, Perez-Diaz F, Jouvent R. Alexithymia and anxiety; compounded relationship? A Psychometric Study. Eur Psychiatry 1999;14:372-378. https://doi.org/10.1016/S0924-9338(99)00233-3
  16. Celikel F C , Saateioglu O. Alexithymin and anxiety in female chronic pain patients. Ann Gen Psychiatry 2006;5:13-17. https://doi.org/10.1186/1744-859X-5-13
  17. Honkalnmpi K, Saarinen P, Kintikka J, Virtanen V, Viinamaki H. Factors associated with alexithymia in patients with suffering from depression. Psychother Psychosom 1999; 68:270-275. https://doi.org/10.1159/000012343
  18. Honkalampi K, Hintikka J, Saarine P, Lehtonen J, Viinamaki H. Is alexithyamia a permanent feature in depressed patients? Results from 6-months follow-up. Psychother Psychosom 2000;69:303-308. https://doi.org/10.1159/000012412
  19. Honkalampi K, Kintikka J, Laukkanen E, Lehtonen J, Viinamaki H. Alexithymia and depression; a prospectivc study of patients with major depressive disorder. Psychosomatics 2001;42:229-234. https://doi.org/10.1176/appi.psy.42.3.229
  20. Rufer M, Moergeli H, Moritz S, Drabe N, Weidt S. Alexithymia and non-treatment: An internet based study of 312 people with chronic anxiety, Compr Psychiatry 2014;55:179-187. https://doi.org/10.1016/j.comppsych.2013.06.007
  21. Nardelli S, Pentassuglio I, Pasquale C, Ridola L, Moscucci F, Merli M. et al. Depression, anxiety, and alexthymia symptoms are major determinants of health related quality of life (HRQOL) in cirrhotic patients. Metab Brain Dis 2013;28:239-243. https://doi.org/10.1007/s11011-012-9364-0
  22. Kauhanen J, Kaplan GA, Cohen RD, Julkunen J, Salonen JT. Alexihtymia and risk of death in middle-aged men. J Psychosomatic Research 1996;41:541-548. https://doi.org/10.1016/S0022-3999(96)00226-7
  23. American Psychiatric Association. Diagnostic and Statistical Manual of Mentnl disorders, fourth edition-text revision (DSM-IV-TR). Washington D.C.: American Psychiatric press;2000.
  24. Derogatis LR, Rickels K, Rocks AF. The SCL-90-R and the MMPI: a step in the validation of a new self-report scale Br J Psychiatry 1976;128:280-289. https://doi.org/10.1192/bjp.128.3.280
  25. Lee YH, Rim HD, Lee JY. Development and validation of a korean version of the 20-item Toronto Alexithymia scale (TAS-20K) J Korean Neuropychiatr Assoc 1996;35:888-899.
  26. Yoon JS, Kook SH, Lee MS. A preliminary study on Korean version of thc Smith Klein Beecham quality of Life scale. J Korean Neuropychiatr Assoc 1998;37:280-295.
  27. Bagby RM, Parker JDA, Taylcr GJ. The 20-item Torontto Alexithymia Scale-I: Item selection and cross-validation of the factor structure. J Psychosom Res 1994;38:23-32. https://doi.org/10.1016/0022-3999(94)90005-1
  28. Kim KI, Won HT. Lee JH, Kim KY. Standardization study of symptom checklist-90 in Korea .. I: Characteristics of normal responses. J Korean Neuropsychiatry Assoc 1978;17:449-458.
  29. Kim KI. Kim JH, Won HT. Korean manual of symptom checklist- 90-revision. Seoul: Jungangjuksung Publisher;1984.
  30. Stoker MJ. Dunbar GC, Beaumont G. The Smithklein Beccham 'Qaulity of Life' scale: A Validation and reliability study in patients with affective disorder Qunl Life Res 1992:1:385-395. https://doi.org/10.1007/BF00704433
  31. Beck AT, Epstein N, Brown G, Steer RA. An Inventory for measuring clinical Anxiety: Psychomctric Properties. J Consult Clin Psychol 1988;56:893-897. https://doi.org/10.1037/0022-006X.56.6.893
  32. Yook SP, Kim ZS. A Clinical study on the Korean version of Beck Anxiety Inventory: Comparative study of patient and non-patient. Korean J Clin Psychol 1997;16: 185-197.
  33. Beck AT, Ward CH, Memdelson M, Mook J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:53-63.
  34. Rhee MK, Lee YH, Park SH, Sohn CH, Chung YC Hong SK. et al. A Standardization study of Beck Depression Inventory I-Korean version: Reliabilityand Factor analysis. Korean J Psychopathol 1995;4:77-95.
  35. Son SH, Jo HY, Rim HD, Kim JH, Kim HW, Bae GY, et al. A Comparative study on alexithymin in depressive, somatoform, Anxiety, and Psychotic Disorders among Korean. Psychiatry Investig 2012;9:325-331. https://doi.org/10.4306/pi.2012.9.4.325
  36. Leweke F, Leichsenring F, Kruse J, Hermes S. Is alexithymia associated with specific mental disorder? Psychcpathology 2012;45:22-28. https://doi.org/10.1159/000325170
  37. Bankier B, Aigner M, BAch M. Alexithymia in DSM-IV disorder: comparative evaluation of somaotoform disorder, panic disorder, obsessive compulsive disrorder, and depression, Psychosomatics 2001;42:235-240. https://doi.org/10.1176/appi.psy.42.3.235
  38. Mattila AK, Saarni SI, Salminen JK, Huhtala H, Sintonen H, Joukamaa M. Alexithymia and Health-related Quality of life in a General Population. Psychosomatics 2009;50:59-68 https://doi.org/10.1176/appi.psy.50.1.59
  39. Lumley MA, Norman S. Alexithymia and heathcareutilization. Psychosom Med 1996;58:197-203. https://doi.org/10.1097/00006842-199605000-00001
  40. Nardelli S, Pentassuglio I, Pasquale C, Ridola L, Moscucci F, Merli M. et al. Depression, anxiety, and alexthymia symptoms are major determinants of health related quality of life (HRQOL) in cirrhotic patients. Metab Brain Dis 2013;28:239-243. https://doi.org/10.1007/s11011-012-9364-0
  41. Rufer M, Moergeli H, Moritz S, Drabe N, Weidt S. Alexithymia and non-treatment: An internet based study of 312 people with chronic anxiety. Compr Psychiatry 2014;55:179-187. https://doi.org/10.1016/j.comppsych.2013.06.007
  42. Schonfeld WH, Verooncoeur CJ, Fifer SK, Lipschutz RC, Lubeck EP, Besching DP. The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder. J Affect disord 1997;43:105-119. https://doi.org/10.1016/S0165-0327(96)01416-4
  43. Kauhanen J, Kaplan GA, Cohen RD, Julkunen J, Salonen JT. Alexihtymia and risk of death in middle-aged men. J Psychoscmatic Research 1996;41:541-548. https://doi.org/10.1016/S0022-3999(96)00226-7
  44. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, et al. The functioning and well-being of deprcssed patients; results from the Medical outcomes study. JAMA 1989;262:915-920.
  45. Simon GE, Von Korff M, Heiligenstein JH, Revicki DA, Grothnus L. Katon W, et al. Initial antidepressant choice in primary care. Effectiveness and cost of fluoxetine vs tricyclieantidepressants. JAMA 1996;275:1897-1902. https://doi.org/10.1001/jama.1996.03530480039038
  46. Lamers F, von Oppnen P, Comijs HC, Smit JH, Spinhoven P. van Balkom AJL, et al. Comorbidity patterns of anxiety and depressive disorders in a large Cohort Study: The Netherland Study of Depression and Anxiety (NESDA). J Clin Psychiatry 2011;72:341-348. https://doi.org/10.4088/JCP.10m06176blu
  47. Pennix BWJH, Nolen W, Lamers F, Zitman FG, Smit JH, Spinhoven PS, et al. Two-year course of depressive and anxiety disorder: Result from the Netherland Study of depression and anxiety (NESDA). J Affect Dis 2011 :133:76-85. https://doi.org/10.1016/j.jad.2011.03.027