Prevalence of somatic symptom disorder and influence of alexithymia in women with thyroid diseases

Background: Although the high prevalence of comorbid psychopathology is well acknowledged in thyroid disease, less is known about the prevalence of somatic symptom disorder (SSD) and underlying psychological factors. Alexithymia is one of the psychological dimensions that has shown to affect the subjective burden of chronic diseases. The purpose of this study was to investigate the prevalence of SSD and the related influence of alexithymia in female patients with thyroid diseases. Methods: A convenience sample of 583 adult women with thyroid diseases was recruited through online platforms and assessed for anxiety and depression (HADS) and alexithymia (TAS-20). SSD was evaluated with the Somatic Symptom Scale-8 (SSS-8 for criterion A) and the Whiteley Index-7 (WI-7 for criterion B) and >6 months disease duration (for criterion C). Results: The prevalence of SSD was 58.7%. SSD subjects had significantly higher anxiety, depression, and alexithymia than those without SSD. SSS-8 was positively predicted by anxiety, TAS-DIF, and TAS-DDF at 31%. WI-7 was found to be positively predicted by medical comorbidity, TAS-DIF, anxiety, and depression, accounting for 33% of the variance. Limitations: Cross-sectional study, self-reported assessment, social desirability, online survey. Conclusions: Given the high prevalence of SSD, clinicians are encouraged to use screening procedures for assessing patients with thyroid diseases for emotional distress as well as underlying psychological factors such as alexithymia.