Document Type : Original Article


1 Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences

2 cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran


Background: Although psychological factors are now recognized as playing a significant
and independent role in the development of coronary heart disease (CHD) and its
complications, many of these factors are correlated with each other. The present study is
aimed at examining the association between alexithymia and anxiety depression, stress,
quality of life, and social support in CHD patients. Materials and Methods: In this research
398 patients with coronary heart disease (166 females and 232 males) from the city of
Isfahan were selected using random sampling. The tools used included depression, anxiety,
and stress scale (DASS-21), Health-related to Quality Of Life (HRQOL-26), Multiple Scale
Perceived Social Support (MSPSS-12), and the Toronto Alexithymia Scale (TAS-20). The data
were analyzed using structural equation modeling by using the Statistical Package for Social
Science (SPSS21) (IBM Corp: Armonk, New York.U.S.) and Asset Management Operating
System (AMOS21) SPSS, an IBM Company: Chicago, U.S. Software. Results: Results of
the structural equation model showed an acceptable goodness of fit, for the explanation
alexithymia that was significantly associated with lower HRQOL and social support and
increasing anxiety, depression, and stress. Conclusions: Alexithymia may increase anxiety,
depression, and stress and can be a predisposing factor to poorer HRQOL and social


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