In fibromyalgia, problems of affect regulation are considered important. Alexithymia, too, is related to disturbed affect regulation. Recognising alexithymia is important with regard to the doctor-patient relationship, the pitfalls in this relationship and the therapeutic strategy.
To look into the prevalence of alexithymia in fibromyalgia and find out which measures were used.
We reviewed the literature systematically using Medline, PubMed and Cochrane and key words.
We found 11 relevant studies which revealed a significantly high prevalence of alexithymia in fibromyalgia patients, namely between 15 and 52%, whereas the prevalence in the general population was only 6 to 8%. All of these studies used the Toronto Alexithymia Scale (20-item or 26-item version) as the only test for alexithymia. Male fibromyalgia patients were not examined adequately, nor were patients in a residential setting. Three studies used patients with a painful chronic condition as a control group, but we did not find any studies that involved psychiatric control groups.
In view of the high prevalence of alexithymia and the implications of this for therapy, we recommend that patients with fibromyalgia should be screened systematically for alexithymia. Further research involving male patients and residential fibromyalgia patients is required and future studies will have to include psychiatric control groups.