Alexithymia is a term denoting a deficit in the ability to differentiate emotional from physical states and to identify and describe one's feelings, as well as a preference for external oriented thinking. Alexithymia has been linked with various somatic and psychosomatic diseases, especially with chronic pain. The aim of this study was to evaluate the association between alexithymia and symptoms of temporomandibular disorders (TMD) as well as oro-lingual and dental pain, in a large representative population sample of young adults. The study was a part of the 31-year follow-up study of the Northern Finland Birth Cohort originally consisting of 12058 live births in the year 1966. In 1997, 4893 subjects living in northern Finland or in the capital area, who participated in a field study of the project and later returned a postal questionnaire, made up the sample of this study. Information concerning symptoms of TMD and oro-lingual and dental pain was collected from the subjects. To assess alexithymia, the Toronto Alexithymia Scale-20 (TAS-20) was used. In addition, information about depression, marital status and self-rated health was collected. The proportion of alexithymics (TAS score over 60) was higher in subjects with the most orofacial symptoms than in asymptomatic subjects. In men, alexithymia associated significantly with facial pain, difficulties in mouth opening, oro-lingual pain and dental pain, and in women with pain on jaw movement and dental pain. After adjusting for depression, marital status, and self-rated health, a significant association remained between alexithymia and the symptoms mentioned, except for facial pain in men. It can be concluded that alexithymia is connected with orofacial symptoms. Clinicians treating these symptoms should be familiar with the concept of alexithymia.
We examined the prevalence of alexithymia and its associations with sociodemographic factors in a population cohort. The study forms part of the Northern Finland 1966 Birth Cohort. The original material consisted of all 12,058 live-born children in the provinces of Lapland and Oulu in Finland with an expected delivery date during 1966. The material represents 96% of all births in the region. In 1997, a 31-year follow-up study was conducted on a part of the initial sample. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was given to 5,993 subjects; 84% returned the questionnaire properly answered. It is known that alexithymia is associated with psychological distress. This was measured with the 25-item version of the Hopkins Symptom Check List (HSCL-25). The prevalence of alexithymia (TAS-20 score > 60) was 9.4% in male and 5.2% in female subjects. Alexithymia was associated with poor education and low income level and it was more common among unmarried subjects. After adjusting for psychological distress, these associations remained statistically significant. The prevalence of alexithymia was higher in men than in women and alexithymia was associated with poor social situation. As far as we know, this was the first study to assess the prevalence of alexithymia and its associations with sociodemographic factors in a large and representative cohort sample, adjusted for psychological distress.