Alexithymia and cancer-related fatigue: a controlled cross-sectional study

The study aims to investigate the alexithymia construct in patients with a recent or longtime diagnosis of cancer as well as in healthy people, and whether alexithymia and fatigue are linked in the mentioned groups.

A first group, diagnosed less than 3 months previously (n = 63), and a second group whose cancer diagnosis dated back more than 30 months (n = 53), matched for sex, age, educational level and cancer site were assessed. Matched healthy controls (n = 50) were also evaluated. Alexithymia was assessed with the Toronto Alexithymia Scale-20, while fatigue was assessed with the Brief Fatigue Inventory.

Alexithymia scores were higher in the recently diagnosed group than in the group with a longtime cancer diagnosis (t = 2.18, P < 0.05). Both groups had higher scores than controls (t = 4.3, P < 0.001; t = 2.01, P < 0.05). Alexithymic subjects were 45.6% in the recently diagnosed and 21.4% in the longtime diagnosed group (Chi(2) = 6.3, P < 0.05) and 18% in controls. Fatigue was more severe in patients with a longtime diagnosis compared with recently diagnosed patients (t = 7.079, P = 0.000). A weak but significant association between fatigue and alexithymia was found in recently diagnosed patients (r = 0.27.2; P < 0.05).

Our study confirms that alexithymia scores are higher in cancer patients than in controls. The study suggests that alexithymia could be considered a dynamic reaction to illness in recently diagnosed patients, declining during subsequent phases. High fatigue rates in patients with a longtime diagnosis of cancer underline the role of the long course of illness in the perception of fatigue. The association between fatigue and alexithymia was weak in the recently diagnosed group and not significant in patients with a longtime diagnosis, in whom fatigue was an important complaint.