Publication:

A cross-sectional analysis of clinical, hematological and psychosocial factors associated with alexithymia and somatic symptoms in patients with chronic kidney disease: insights from a South Indian cohort

Background Chronic kidney disease (CKD) is increasingly recognized as a biopsychosocial condition, with emotional dysregulation and somatic symptoms representing important yet underexplored dimensions. This study aimed to examine the prevalence and predictors of alexithymia and somatic symptoms in CKD patients, highlighting clinical, laboratory and psychosocial interactions.

Methods A cross-sectional study was conducted among 130 CKD patients (mean age: 54.9±13.8 years; 58.5% male). Psychometric assessments included the Toronto Alexithymia Scale (TAS-20) and the Patient Health Questionnaire (PHQ-15). Data were analyzed using Kruskal-Wallis, Mann-Whitney U, Spearman correlations and univariate and multivariate regression models.

Results Alexithymia was present in 50.8% of participants, while somatic symptoms were reported in 46.9%. TAS scores were significantly associated with age (p=0.021) and diabetes mellitus (p=0.016). PHQ-15 scores showed limited associations, with significant differences across age groups (p=0.039) and borderline associations with CKD stage (p=0.052). Red blood cell (RBC) count emerged as the strongest predictor of both TAS (β=0.923, p<0.001) and PHQ-15 (β=0.239, p=0.006) scores. The multivariate model explained 85.4% of TAS variance (Adjusted R²=0.854), whereas PHQ-15 scores were less predictable (Adjusted R²=0.068). Caregiver burden was significantly higher among patients with alexithymia (p<0.0001).

Conclusions Alexithymia and somatic symptoms are highly prevalent in CKD and shaped by biological and psychosocial determinants. Incorporating broader psychosocial assessments and caregiver support into CKD management could enhance patient outcomes and alleviate family burden.