The Comorbidity of Back and Cervical Pain, Anxiety, Depression and Alexitymia

Patients with alexithymia have difficulties in verbal description of their sensations. The reasons of this specific cognitive modality have not been explained entirely yet, so there is an urge to use psychometric instruments to analyze this peculiarity and to measure alexithymia simultaneously with other parameters (in neurology, different types of pain, anxiety, depression, dizziness). The aim of the study was to identify the presence or absence of statistically significant correlation between nonspecific cervical and back pain, anxiety, depression, and alexithymia. The authors observed 435 patients with cervical and back pain complaints. After neurological examination, there were revealed 156 patients aged 18-50 years (average age 38.2 +/- 10.1 years, 89 females and 67 males) with nonspecific cervical and back pain. All patients passed through the Russian language version of the 20-point Toronto alexithymia scale (TAS-20) and were divided into three groups: high level of alexithymia (group A), border zone (group B), and low level of alexithymia (group C). The patients were also divided into 2 subgroups: acute pain and chronic pain. All patients passed through the assessment of pain severity, disability index, satisfaction with life index (according to VAS scale), and anxiety and depression (according to Hospital Anxiety and Depression Scale (HADS)). Statistical assessment included the Shapiro-Wilk test for determining the type of data distribution, methods of descriptive statistics with the presentation of data in the form of an average value and standard deviation, and contingency table method for comparing the studied groups. The critical level of significance (p) in testing statistical hypotheses in the study was taken 0.05. Processing of the obtained data showed that patients with high level of alexithymia had statistically significant higher rates of pain severity, disability index, and level of anxiety and depression, and significantly lower satisfaction with life index than patients with border and low levels of alexithymia. The results also show that the concrete type on nonspecific pain (acute or chronic) is not connected with the risk of comorbidity with anxiety, depression, and alexithymia. Thus, in clinical practice, it is advisable to test patients with pain complaints also presenting tools to identify the level of anxiety and alexithymia.