Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis

Fatigue in Hemodialysis Patients: A Comparative Analysis with Healthy Controls

This study investigates fatigue and quality of life in hemodialysis patients, examining the influence of demographic and clinical factors on these outcomes. A cohort of 115 hemodialysis patients and 112 healthy controls completed the Modified Fatigue Impact Scale (MFIS), the shorter MFIS-5, and the WHOQOL-BREF quality of life assessment. The findings indicate that hemodialysis patients experience significantly higher levels of fatigue, which correspond with lower quality of life, particularly in the physical and psychological domains, compared to healthy controls. Male patients reported significantly higher levels of fatigue and lower quality of life scores, whereas younger patients demonstrated relatively better outcomes. Extended dialysis sessions exceeding four hours were associated with poorer social well-being, and educational attainment was positively linked with physical and environmental quality of life domains. However, marital status did not show a significant effect. The study validates the consistency between MFIS and MFIS-5 scores, recommending MFIS-5 for time-sensitive clinical use without compromising accuracy. These results underscore the need for individualized, multi-dimensional approaches to fatigue management in hemodialysis patients, emphasizing interventions that address physical, psychological, and social well-being to enhance overall quality of life. The findings highlight specific factors that may guide tailored support strategies to improve patient outcomes in this population.

Association of Ego Defense Mechanisms with Electrolyte and Inflammation Marker Levels, Interdialytic Weight Gain, Depression, Alexithymia, and Sleep Disorders in Patients Undergoing Chronic Hemodialysis

Background/Objectives: Ego defense mechanisms are subconscious processes that help individuals cope with stressors from both external and internal realities. They are divided into three levels based on their adaptive function. Patients undergoing chronic hemodialysis are those who have been treated with this method for longer than three months. Only a few studies have examined the defense mechanisms in hemodialysis patients. Our study aimed to examine the association between ego defense mechanisms and alexithymia, depression, and sleep disorders, as well as clinical and biochemical variables, in a group of 170 hemodialysis patients. Methods: We used the Defense Style Questionnaire-40, the Toronto Alexithymia Scale-26, the Pittsburgh Sleep Quality Index, and the Hamilton Depression Inventory as our analyses methods. Clinical and biochemical variables, along with interdialytic weight gain, were measured before the hemodialysis session. Results: There was a positive correlation between the affect displacement and dissociation with leukocyte levels (Spearman's rho = 0.192, p = 0.02; rho = 0.165, p = 0.04), and between autistic fantasy and phosphorus levels (rho = -0.163, p = 0.04). Depressive HD patients had higher levels of somatization, affect displacement, and splitting compared to the HD patients without depression (Man-Whitney U test, p = 0.005, p = 0.022, p = 0.045). There were higher levels of immature defense mechanisms in the group of patients with alexithymia than in the group without alexithymia (Mann-Whitney U test, p < 0.001). Conclusions: The immature defense mechanisms were our research model's strongest predictive factor of alexithymia (OR = 1.87, 95% CI 1.27 to 2.75).

Alexithymia and post-traumatic stress disorder symptoms in Chinese undergraduate students during the COVID-19 national lockdown: The mediating role of sleep problems and the moderating role of self-esteem

OBJECTIVE

This study examined whether sleep disturbance was a mediator between alexithymic traits and post-traumatic stress disorder (PTSD) COVID-19 pandemic-related stress symptoms, and explored whether self-esteem moderated the alexithymic contribution to poor sleep and PTSD symptoms.

METHOD

A representative sample of young adults (N = 2,485) from six universities in Southwest China completed online self-report surveys on alexithymia, sleep, PTSD, self-esteem, sociodemographic information, and health-related behaviors.

RESULTS

High alexithymic young adults were found to be more likely to have higher sleep problems and higher PTSD symptoms. The moderated mediation model showed that sleep problems mediated the associations between alexithymia and PTSD symptoms. Alexithymic people with lower self-esteem were more likely to have elevated PTSD symptoms and sleep problems than those with higher self-esteem.

CONCLUSION

Targeted psychological interventions for young people who have difficulty expressing and identifying emotions are recommended as these could assist in reducing their post-traumatic psychophysical and psychological problems. Improving self-esteem could also offer some protection for trauma-exposed individuals.