Alexithymia and illness behaviour among female Indian outpatients with somatic symptoms, Sarkar J. and Chandra P. Indian Journal of Psychiatry, Vol. 45, No. IV, 229-233.

The study of Sarkar and Chandra (2003) attempts to show the prevalence of alexithymia and its association with abnormal illness behaviour among a socioculturally homogeneous group of patients with somatic symptoms. A somewhat similar study (Radhika 1997) was conducted in a general hospital psychiatry unit on 71 patients (a rather sociocultually heterogeneous but with 70% Hindu population) presenting with somatic symptoms to the medical and surgical departments and referred for psychiatric help. The prevalence of alexithymia measured by the Toronto Alexithymia Scale was rather low (7%) among this population (mean score 58.53 +_ 10.95). The results of one way analysis of variance on the score of alexithymia among the diagnostic groups (anxiety, depressive and somatoform disorder) showed that the score of alexithymia was significantly higher among those with somatoform disorder than among those with anxiety disorder (p=0.001). A higher (a trend toward significance, p=0.077) alexithymia scores were observed among the smaller number of patients (N=15) fulfilling the criteria of abnormal illness behaviour as per Illness Behaviour Assessment Schedule than the other bigger group (N=56) who did not. Again, a trend of significant positive correlation (r = 0.232, p = 0.05) was found between the alexithymia scores and the number of somatic symptoms present in an individual patient in the entire study sample as well as among the two gender groups separately. We also looked into the relation between alexithymia characteristics and the range of coping mechanisms of the patients. A non-significant negative correlation was found only in the group of male patients. Although such studies tend to indicate some kind of clinical association of alexithymia, certain fundamental issues remain to be addressed. Is the construct of alexithymia cross culturally applicable? Is it possible to differentiate between trait and state of alexithymia among the community population? Does the presence of alexithymia tend to have any clinical validity? Unless these issues are thoroughly addressed and resolved in future research the relevance of alexithymia to our population will continue to remain in doubt in the sceptic mind of the clinician. REFERENCES Radhika C.R. (1997) : A study of alexithymia, illness behaviour and coping repertoire among the patients with somatic symptoms, M.D. dissertation submitted to Mangalore University. Radhika and Sengupta raise many pertinent issues about our study (Sarkar and Chandra, 2003) in their letter to the editor. The discrepancy between the rates of alexithymia between their and our study may be on account of …