ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychology for Clinical Settings
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1570190
The mediating effect of alexithymia in the symptom burden and depression in patients with maintenance hemodialysis
Provisionally accepted
- BenQ Medical Center, Nanjing, China
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Aim: This study aimed to investigate the prevalence of alexithymia among patients receiving maintenance haemodialysis (MHD) and whether it plays a role in the relationship between symptom burden and depression in this population.Background: The prevalence of depression among patients undergoing MHD is increasing.Numerous studies have found strong links between alexithymia, symptom burden, and the development of depression in this population. However, the underlying mechanisms and alexithymia's specific mediating role in the relationship between symptom burden and depression are poorly understood and have received little attention in the existing literature.Methods: This study included 380 MHD patients in a haemodialysis centre, with a mean age of 58.98 ± 13.86 years, using a self-designed patient general information questionnaire, disease-related information questionnaire, dialysis patient symptom burden scale, depression scale, and Toronto Alexithymia Scale (TAS-20). A regression model of the factors influencing depression was developed using structural equation modelling.Results: MHD patients had a DFSSBI score of 77.41 ± 45.74, a TAS-20 score of 55.36 ± 11.17, and a PHQ-9 score of 6.07 ± 4.60. The burden of symptoms was positively correlated with alexithymia and depression (r = 0.367, 0.776, P = 0.000). The regression model had a high goodness of fit (2/df = 1.604, RMSEA = 0.040, GFI = 0.986, CFI = 0.999, TLI =0.997). The structural equation model analysis found the following: symptom burden was a positive predictor of alexithymia, β = 0.296, P < 0.001; alexithymia was a positive predictor of depression, β = 0.752, P < 0.001; and symptom burden was a positive predictor of depression, β = 0.141, P < 0.001.The level of depression in MHD patients is closely related to the burden of symptoms and alexithymia, with alexithymia serving as a partial intermediary between the two. Addressing the emotional well-being and symptom load of MHD patients is critical to relieving their depressive symptoms.
Keywords: Maintenance haemodialysis, alexithymia, Depression, Symptom burden, Mediating effect
Received: 03 Feb 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 liu, Xia, wang, yuan, xiao and xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: leijuan xiao, BenQ Medical Center, Nanjing, China
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