Alexithymia in patients with type 2 diabetes mellitus: the role of anxiety, depression, and glycemic control

Figures & data

Table 1 Mean scores for the Toronto Alexithymia Scale and the prevalence of alexithymia

Variables	X ± SD	Min–max	n (%)
TAS-1	17.41±5.93	6–29
TAS-2	14.85±3.51	8–24
TAS-3	24.65±4.71	9–35
TAS-20	56.92±9.05	33–85
≤60 nonalexithymic			203 (62.3)
≥61 alexithymic			123 (37.7)

Notes: TAS-1, Difficulty Identifying Feelings; TAS-2, Difficulty Describing Feelings; TAS-3, Externally Oriented Thinking; TAS-20, Toronto Alexithymia Scale.

Abbreviations: max, maximum; min, minimum; SD, standard deviation; X, mean.

Table 2 Mean scores for the anxiety and depression subscales

Variables	n (%)	X ± SD	Min–max
Anxiety
≤10 points	220 (67.5)	8.91±2.88	3–18
≥11 points	106 (32.5)
Depression
≤7 points	179 (54.9)	9.36±3.92	2–21
≥8 points	147 (45.1)

Abbreviations: max, maximum; min, minimum; SD, standard deviation; X, mean.

Table 3 Alexithymia status of the participants in terms of some of their characteristics

Variables (n=326)	Nonalexithymic TAS-20 (≤ 60)		Alexithymic TAS-20 (≥61)		χ^2	P-value
	n	%	n	%
Age (years)					0.984	0.321
45–64	73	58.9	51	41.1
≥65	130	64.4	72	35.6
Sex					9.515	0.002
Female	93	54.4	78	45.6
Male	110	71.0	45	29.0
Education level					0.033	0.855
Primary school and lower	130	61.9	80	38.1
Secondary and high school	73	62.9	43	37.1
Marital status					3.198	0.074
Married	122	58.7	86	41.3
Single/widow	81	68.6	37	31.4
Employment status					13.006	<0.001
Working	4	22.2	14	77.8
Does not work	199	64.6	109	35.4
Perceived income level					4.594	0.101
Good	10	62.5	6	37.5
Moderate	184	63.9	104	36.1
Bad	9	40.9	13	59.1
Duration of illness (years)					9.924	0.019
<1	53	66.3	27	33.8
1–5	64	73.6	23	26.4
6–10	46	55.4	37	44.6
≥11	40	52.6	36	47.4
Presence of a comorbid chronic disease					0.561	0.454
Yes	127	60.8	82	39.2
No	76	65.0	40	35.0
Type of treatment					2.508	0.113
Insulin + diet	114	58.8	80	41.2
Oral antidiabetic + diet	89	67.4	43	32.6
Presence of complications					3.252	0.071
Yes	46	54.1	39	45.9
No	157	65.1	84	34.9
HbA1c level (%)					9.372	0.002
<7.0	87	73.1	32	26.9
≥7.0	116	56.0	91	44.0
Anxiety					37.206	<0.001
≤10 points	162	73.6	58	26.4
≥11 points	41	38.7	65	61.3
Depression					22.241	<0.001
≤7 points	132	73.7	47	26.3
≥8 points	71	48.3	76	51.7

Abbreviation: TAS-20, Toronto Alexithymia Scale.

Table 4 Correlation between alexithymia and HbA1c, anxiety, and depression

Variables	1	2	3
1. Alexithymia	1	–	–
2. HbA1c	0.814**	1	–
3. Anxiety	0.654**	0.528**	1
4. Depression	0.796**	0.675**	0.683**

Note:

** P<0.01.

Abbreviation: HbA1c, glycated haemoglobin.

Table 5 Multivariate analysis of factors affecting alexithymia in patients with type 2 DM

Variables (n=326)	β	SE	P-value	OR (95% CI)
Age (years)
≥65				1.00
45–64	0.204	0.331	0.538	1.23 (0.64–2.34)
Sex
Male				1.00
Female	0.155	0.309	0.617	1.17 (0.63–2.14)
Education level
Secondary and high school				1.00
Primary school and lower	0.321	0.241	0.118	2.11 (0.71–3.43)
Employment status
Does not work				1.00
Working	1.221	0.376	0.001	2.63 (2.04–3.98)
Perceived income level
Good				1.00
Moderate	0.044	0.718	0.951	1.04 (0.26–4.27)
Bad	1.046	0.891	0.241	2.84 (0.49–6.32)
Duration of illness (years)
<1				1.00
1–5	0.660	0.392	0.092	0.52 (0.24–1.11)
6–10	0.542	0.380	0.154	1.71 (0.82–3.62)
≥11	0.373	0.379	0.324	1.45 (0.69–3.05)
Presence of a comorbid chronic disease
No				1.00
Yes	0.346	0.313	0.269	0.71 (0.38–1.31)
Type of treatment
Oral antidiabetic + diet				1.00
Insulin + diet	0.455	0.281	0.141	1.74 (0.84–3.01)
Presence of complications
No				1.00
Yes	0.243	0.312	0.436	1.28 (0.69–2.35)
HbA1c level (%)
<7				1.00
≥7	0.741	0.280	0.008	2.09 (1.21–3.63)
Anxiety
≤10				1.00
≥11	1.328	0.284	0.000	3.77 (2.16–6.58)
Depression
≤7 points				1.00
≥8 points	0.454	0.291	0.019	2.57 (1.48–3.78)

Notes: Hosmer–Lemeshow test: 0.784, Nagelkerke R²: 0.241.

Abbreviations: CI, confidence interval; DM, diabetes mellitus; HbA1c, glycated haemoglobin; OR, odds ratio; SE, standard error.