Investigation of alexithymia levels in fibromyalgia before and after treatment.

Objectives: The aim of the study was to investigate changes in alexithymia scores upon fibromyalgia (FM) treatment.

Methods: This prospective observational cohort study was conducted at the Istanbul Physical Medicine and Rehabilitation Training and Research Hospital. Patients diagnosed with fibromyalgia syndrome (FM) according to American College of Rheumatology criteria were included. All participants received duloxetine treatment, combined aerobic exercise. FM symptoms were assessed using Visual Analog Scale (VAS) at baseline and at 6 months, while alexithymia was evaluated using Toronto Alexithymia Scale-20 (TAS-20) at baseline, 3, and 6 months. Statistical analysis included repeated measures ANOVA with Greenhouse-Geisser correction, paired t-tests, and correlation analyses, with adjustments for age, BMI, and daily medication count.

Results: A total of 100 patients completed the study. VAS scores significantly decreased from the baseline (mean ± SD: 7.4±1.2) to 6 months (4.1±1.3; p<0.001). TAS-20 total scores also showed significant reductions at 3 months (57.8±7.6) and 6 months (54.2±7.1) compared to the baseline (61.5±7.9; p<0.001). Improvements in TAS-20 scores was correlated with reductions in VAS scores (r=0.41, p=0.002).

Conclusions: Combined duloxetine treatment and aerobic exercise could significantly improve both alexithymia symptoms and pain levels in FMS patients over a six-month period. Higher baseline alexithymia scores were associated with greater improvements in both alexithymia and pain symptoms, suggesting that patients with more severe initial alexithymia may benefit more from this treatment.

Clinical trial no: NCT06841302 (https://www.

Clinicaltrials: gov/ registration date: 2025-02-18).