Prevalence and correlates of alexithymia in drug-resistant epilepsies

Alexithymia, characterized by difficulty identifying and expressing emotions, is commonly observed in individuals with psychiatric and neurological disorders. However, its prevalence in patients with epilepsy (PWE), particularly in those with drug-resistant epilepsy (DRE), remains under-researched. This study investigates the prevalence of alexithymia in patients with DRE and explores its associated factors.

We conducted a retrospective observational study of 118 adult patients with focal DRE undergoing presurgical evaluation at Bordeaux University Hospital. Alexithymia was assessed using the Toronto Alexithymia Scale-20 (TAS-20), while psychiatric symptoms were evaluated with validated scales. Data on demographic characteristics, epilepsy duration, seizure frequency, antiepileptic drug use, and localization of the epileptogenic zone (EZ) were collected and analyzed using logistic regression models.

Alexithymia was identified in 40.7 % of patients. Depression and anxiety were significantly associated with alexithymia (p < 0.01), whereas no correlation was observed between alexithymia and the localization or lateralization of the EZ.

These findings suggest that alexithymia is prevalent among patients with DRE, with significant associations to depression and anxiety. The high prevalence of affective symptoms underscores the importance of early identification and intervention for alexithymia to improve outcomes in patients with DRE.