Pain sensitivity, alexithymia, and depression in patients with eating disorders: are they related?

A decreased sensitivity to painful stimuli and high scores for alexithymia and depression have been observed in patients with eating disorders. We investigated the relationship between these factors in 22 patients with anorexia nervosa, 18 patients with bulimia nervosa, and 32 healthy subjects. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale and depression using the Beck Depression Inventory. Patients with bulimia exhibited significantly higher thresholds to mechanically induced pain than healthy subjects. Thresholds to thermally induced pain in patients with anorexia or bulimia were similar and significantly higher than in the healthy subjects. Alexithymia and depression scores were significantly higher in anorexic and bulimic patients than in the healthy subjects. Analyses of covariance revealed that the degree of alexithymia did not influence thresholds to thermally and mechanically induced pain, whereas the severity of depression affected to some extent the threshold to thermally induced pain.