{
  "abstract": "Background Alexithymia, a personality trait characterised by difficulty in identifying and expressing emotions, may contribute to the onset and clinical presentation of functional motor disorders (FMDs), although this association remains underexplored.Methods From the Italian Registry of FMDs, we selected individuals recruited between November 2011 and January 2023, diagnosed with FMD according to Gupta and Lang criteria and assessed for various neurological and psychological features with validated rating scales. The main statistical analysis included regression models using the Toronto Alexithymia Scale 20 items as an explanatory variable for a set of clinical measures, adjusting for sociodemographic factors and correcting for multiple testing.Results In a cohort of 483 individuals, 20.7% had possible alexithymia and 31.5% had definite alexithymia. Higher levels of alexithymia were strongly associated with increased severity of depression (β=0.31, p<0.001), anxiety (β=0.32, p<0.001), general psychological distress (β=−0.27, p<0.001), fatigue (β=0.05, p<0.001) and pain (β=0.32, p<0.001) and moderately associated with a slower onset of FMD (β=0.02, p=0.003). Subscale analyses revealed that difficulties identifying feelings contributed most to these associations. No significant association was observed with motor symptom severity.Conclusions Emotional processing difficulties of individuals with FMD and alexithymia might increase their vulnerability to mental health problems, pain and fatigue, possibly aggravating the overall prognosis. Further research is needed to elucidate the underlying mechanisms linking alexithymia to FMD and to explore the efficacy of interventions targeting emotional awareness and regulation in this population and to prevent long-term mental health burdens.",
  "authors": [
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Giovanni Ostuzzi"
    },
    {
      "affiliations": [
        "Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy"
      ],
      "name": "Christian Geroin"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Chiara Gastaldon"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Federico Tedeschi"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Francesca Maria Clesi"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Giacomo Trevisan"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Giovanni Bidello"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Giovanni Vita"
    },
    {
      "affiliations": [
        "Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Enrico Marcuzzo"
    },
    {
      "affiliations": [
        "Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Angela Sandri"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy"
      ],
      "name": "Luigi M Romito"
    },
    {
      "affiliations": [
        "Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy"
      ],
      "name": "Roberto Eleopra"
    },
    {
      "affiliations": [
        "FND outpatients clinic, Neurology and Stroke Unit, General Hospital of Bolzano, Bolzano, Italy"
      ],
      "name": "Lucia Tesolin"
    },
    {
      "affiliations": [
        "FND outpatients clinic, Neurology and Stroke Unit, General Hospital of Bolzano, Bolzano, Italy"
      ],
      "name": "Ilaria Franch"
    },
    {
      "affiliations": [
        "Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy"
      ],
      "name": "Mario Zappia"
    },
    {
      "affiliations": [
        "Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy"
      ],
      "name": "Alessandra Nicoletti"
    },
    {
      "affiliations": [
        "Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy"
      ],
      "name": "Benedetta Demartini"
    },
    {
      "affiliations": [
        "Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy",
        "Department of Psychology, University of Milano-Bicocca, Milan, Italy"
      ],
      "name": "Veronica Nisticò"
    },
    {
      "affiliations": [
        "IRCCS Neuromed, Pozzilli, Italy"
      ],
      "name": "Nicola Modugno"
    },
    {
      "affiliations": [
        "IRCCS Neuromed, Pozzilli, Italy"
      ],
      "name": "Enrica Olivola"
    },
    {
      "affiliations": [
        "Neurology Unit and Laboratory of digital Neurology and biosensors, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy",
        "Department of continuity of care and frailty and Neurobiorepository and Laboratory of advanced biological markers, Neurology Unit, ASST Ospedali Civili Hospital, Brescia, Italy"
      ],
      "name": "Andrea Pilotto"
    },
    {
      "affiliations": [
        "Neurology Unit and Laboratory of digital Neurology and biosensors, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy",
        "Department of continuity of care and frailty and Neurobiorepository and Laboratory of advanced biological markers, Neurology Unit, ASST Ospedali Civili Hospital, Brescia, Italy"
      ],
      "name": "Alessandro Padovani"
    },
    {
      "affiliations": [
        "Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy"
      ],
      "name": "Giovanni Defazio"
    },
    {
      "affiliations": [
        "Neurological Unit, AOU Sassari, University of Sassari, Sassari, Italy"
      ],
      "name": "Tommaso Ercoli"
    },
    {
      "affiliations": [
        "Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"
      ],
      "name": "Martina Petracca"
    },
    {
      "affiliations": [
        "Department of Advanced Medical and Surgery Sciences, University of Campania – Luigi Vanvitelli, Naples, Italy"
      ],
      "name": "Rosa De Micco"
    },
    {
      "affiliations": [
        "Department of Medical Area, Neurology Unit, ASST di Pavia, Pavia, Italy"
      ],
      "name": "Carlo Dallocchio"
    },
    {
      "affiliations": [
        "Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy"
      ],
      "name": "Marcello Esposito"
    },
    {
      "affiliations": [
        "Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry - Scuola Medica Salernitana, University of Salerno, Baronissi, Italy"
      ],
      "name": "Roberto Erro"
    },
    {
      "affiliations": [
        "Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"
      ],
      "name": "Eleonora Del Prete"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Francesco Amaddeo"
    },
    {
      "affiliations": [
        "WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Corrado Barbui"
    },
    {
      "affiliations": [
        "Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy"
      ],
      "name": "Michele Tinazzi"
    }
  ],
  "title": "Characterising alexithymia in individuals with functional motor disorders: a cross-sectional analysis of the Italian Registry of Functional Motor Disorders",
  "uid": "360bdb03-02e4-571e-b07f-a6fe95690e5a"
}