Spondyloarthritis & psoriatic arthritis
Emotional unawareness in psoriatic arthritis: decoding the impact of alexithymia on pain perception, disease activity, and treatment response
Authors' conclusion
Alexithymia is present in PsA and is linked to increased pain perception, disease activity and treatment burden.
Study context
- Population
- Psoriatic arthritis (PsA) patients on stable biological therapy, three Italian rheumatology centers
- Participants
- 207 patients
- Exposure
- Alexithymic vs non-alexithymic PsA patients
- Alexithymicn = 63
- Outcome
- Prevalence of alexithymia (TAS-20) and its association with disease activity, psychological burden and treatment complexity
- Follow-up
- Last
Methodological detailsobservational, multicentre (three Italian rheumatology centers)
- Observational
- Multicentre (three Italian rheumatology centers)
Main finding
As reported in the abstract
Prevalence of alexithymia (TAS≥61)
Alexithymic
30.4%
63
Observational data: associations, not effects.
Further findings
Pain, disease activity and psychological measures, alexithymic vs non-alexithymic
- Significantly higher pain-VAS, patient and physician global assessment, tender joint count, Pain Catastrophising Scale (PCS), Widespread Pain Index (WPI)+Symptom Severity Scale (SSS) and Beck's Depression Inventory (BDI) scores, and elevated DAPSA, Bath Axial Spondyloarthritis Disease Activity Index (BASDAI), ASDAS-CRP in alexithymic patients
- Inflammatory markers and swollen joint count similar between groups
Treatment burden
- Alexithymic patients underwent multiple biological therapy lines and reported increased csDMARD and NSAID usage
Correlates and independent predictors of alexithymia
- Strong correlation between Toronto Alexithymia Scale (TAS-20) and PCS
- Female sex, concomitant fibromyalgia and higher DAPSA independent predictors of alexithymia (multivariable model)
Original publication
Emotional unawareness in psoriatic arthritis: decoding the impact of alexithymia on pain perception, disease activity, and treatment response. Clin Exp Rheumatol. Published 10 April 2026. doi:10.
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