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. 2025 Apr;275(3):733-742.
doi: 10.1007/s00406-024-01954-1. Epub 2024 Dec 19.

Sex difference in alexithymia and cognitive impairment in chronic schizophrenia: a large sample study based on Chinese Han population

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Sex difference in alexithymia and cognitive impairment in chronic schizophrenia: a large sample study based on Chinese Han population

Kan Yang et al. Eur Arch Psychiatry Clin Neurosci. 2025 Apr.

Abstract

Sex differences in schizophrenia have been noted across domains such as alexithymia and cognitive function; however, how they interact remains unclear. This study aimed to explore sex differences in the relationship between alexithymia and cognitive function in patients with chronic schizophrenia. A total of 695 patients (464 males and 231 females) who met the DSM-IV diagnostic criteria for schizophrenia were recruited in this cross-sectional study. Demographic and clinical data were collected using self-reported questionnaires. We assessed alexithymia using the Toronto Alexithymia Scale (TAS-20), cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and psychiatric symptoms using the Positive and Negative Syndrome Scale (PANSS). Male schizophrenic patients have to read 56.7% of the alexithymia rate, and higher scores on the RBANS visuospatial/constructional, language and total score than female patients (all P < 0.05).Alexithymia patients had lower language than non-alexithymia patients(P = 0.001). In addition, there were significant differences of the correlation scores for men and women in immediate memory and delayed memory (P < 0.001). Our results indicate that there are sex differences in the prevalence comorbid alexithymia symptoms, as well as their association with cognitive function, in patients with schizophrenia. However, a cross-sectional design could not establish definitive causative associations between sex and alexithymia or cognitive function.

Keywords: Alexithymia; Cognitive impairment; Schizophrenia; Sex difference.

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Conflict of interest statement

Declarations. Ethical approval: The study protocol complied with the declaration of Helsinki (revision) and was approved by the institutional review boards of all participating centres. All participants provided written informed consent before their participation in the trial. For participants aged 14–17 years, written informed consent was also obtained from legal guardians. Conflict of interest: No conflict of interest was disclosed for each author.

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