Alexithymia and Immunity: More Than 50 years Later, Where Do We Stand?

AlexithymiaAlexithymia, a neologism coined by Sifneos in the early 1970s has been associated with increased all-cause mortality risk in general population. It is a set of cognitive-affective deficits that describes the inability to identify and verbalize emotions in words. The stressStress alexithymiaAlexithymia hypothesis postulates that alexithymics, because of their inability to cope with and regulate negative emotions, present physiological, behavioral and cognitive-affective disturbances likely to generate chronic stressStress, immune consequences and, consequently, stressStress-related disorders and other illnesses. More than 50 years after the definition of alexithymiaAlexithymia and almost 30 years after the first research exploring the links between alexithymiaAlexithymia and immunity, this chapter reviews the literature on the subject. An analysis of the data in the scientific literature suggests two main models for explaining the effects of alexithymiaAlexithymia on immunity. The first is characterized by a drop in cell-mediated immunity (TH1), with humoral immunity (TH2) more or less affected which could pose an immunosuppression risk and the second one is characterized by an inflammatory reaction with an increase in proinflammatory cytokines which could be a risk factor for cardiovascularCardiovascular and autoimmune diseases. The author postulates that the first model could be supported by the joint activation of the SAM and the HPA axes in a first phase, followed by a decoupling of the axes responsible for activating the Tregs leading to a decrease in TH1–TH2 responses during a second phase. The second model could be the result of CRH hypersecretion associated with glucocorticoidGlucocorticoids resistance.