Psychosomatic aspects of patients on hemodialysis. 3. Clinical usefulness of alexithymia.

The clinical usefulness of alexithymia in dialysis patients was examined from psychosomatic aspects. Before hemodialysis (HD), primary alexithymia was present in 50-53% of HD patients with diabetes. After 2 years' HD therapy, an additional 32-36% of HD patients without diabetes developed secondary alexithymia. In contrast, the prevalence of alexithymia was low in patients receiving continuous ambulatory peritoneal dialysis (CAPD), which requires a higher self-control ability than HD. Alexithymia may reflect dialysis patients' ability to take care of themselves and therefore serve as a useful index in (1) selecting the type of dialysis, either HD or CAPD, and (2) identifying patients on dialysis likely to develop somatic complications due to lack of adequate self-control.