The prevalence of alexithymia in schizophrenia: A systematic review and meta-analysis

Objectives: This study aims to systematically evaluate the prevalence of alexithymia in patients with schizophrenia. Methods: Computer searches were conducted in PubMed, PsycInfo, Web of Science, The Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, and China Biology Medicine (CBM) electronic databases to collect studies that utilized the TAS-20 scale as a measurement tool with clearly defined diagnostic criteria to determine the prevalence of alexithymia in patients with schizophrenia, from the inception of the databases to December 29, 2023. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies, followed by meta-analysis using Stata 16.0 software. Results: A total of 17 studies with 5628 participants were included. The results of the meta-analysis showed that the prevalence of alexithymia in patients with schizophrenia was 35 % (95 % CI: 32-38 %). Subgroup analysis indicated that male gender, smoking, Asian ethnicity, case-control design and divorce were associated with higher rates of alexithymia (all P<0.05). Conclusion: The prevalence of alexithymia in patients with schizophrenia is relatively high (35 %). However, due to limitations in the quality and quantity of included studies, further high-quality literature is needed to confirm the above conclusion.