Objective
We studied the prevalence of alexithymia, its distribution in different age groups in a wide age range, its association with sociodemographic and health-related variables, and its co-occurrence with depression.
Methods
The study forms part of the Health 2000 Study. The original sample comprised 8028 subjects representing the general adult population of Finland. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), and depression was measured with the 21-item Beck Depression Inventory. Altogether, 5454 participants filled in TAS-20 in their mother tongue.
Results
The prevalence of alexithymia was 9.9%. Men (11.9%) were more commonly alexithymic than women (8.1%). Alexithymia was associated with male gender, increasing age, low educational level, poor perceived health, and depression.
Conclusions
The findings were in line with earlier population studies. For the first time, it was possible to analyze the prevalence of alexithymia in a wide age range (30–97 years). International comparative studies are needed.
In the early 1970s, Sifneos [1] coined the term alexithymia. Alexithymia means “no words for feelings” and refers to a personality construct characterized by impoverishment of fantasy, poor capacity for symbolic thought, and inability to experience and verbalize emotions. Increasing evidence shows that alexithymia is associated with several medical conditions and various psychopathological syndromes [2] and mental disorders [3] and [4]. It is thought to reflect a deficit in the cognitive processing of emotion, and alexithymics are thought to lack the capacity for the mental representation of emotions [5], [6] and [7]. These deficiencies are believed to cause an inability to regulate emotions and affect, and therefore to predispose alexithymic individuals to both psychological and somatic symptoms. According to previous studies, since alexithymia is more prevalent among depressed individuals and since alexithymia scores decrease as depression is alleviated, it has been claimed that alexithymia is associated with level of depression and may be a state-dependent phenomenon [8], [9] and [10]. On the other hand, several studies have yielded evidence on both the absolute stability and the relative stability of alexithymia, suggesting that alexithymia is a personality trait [4], [11], [12], [13], [14] and [15].
It is quite surprising that the epidemiology of alexithymia has been the subject of only a handful of papers. Three research groups have studied the epidemiology of alexithymia in different kinds of samples of working-age populations, all of them in Finland [16], [17] and [18]. Two studies have focused on elderly people [19] and [20]. Lane et al. [21] studied both working-age and elderly people. Alexithymia was associated with male gender in four earlier epidemiological studies [16], [17], [18] and [21], with low educational level in four studies [16], [17], [18] and [21], with low social status in four studies [16], [17], [18] and [21], with psychological problems in three studies [17], [19] and [20], and with singleness in one study [18]. The prevalence figures for alexithymia were quite similar across studies on working-age populations, with the prevalence being 9–17% among men and 5–10% among women. In elderly populations, the prevalence of alexithymia was notably higher.
All studies mentioned above differ from each other on several aspects. Disparities in size, age range, and stratification of the samples make it difficult to generalize the findings to adult general populations. The aim of our study was to determine the prevalence of alexithymia and its distribution in different age groups, the sociodemographic and health-related factors associated with it, and its co-occurrence with depression in a representative sample of the whole Finnish adult population.
