Quality of life, alexithymia, and defence mechanisms in patients affected by breast cancer across different stages of illness

G. Marrazzo (1), L. Sideli (2), R. Rizzo (2), A.M. Marinaro (2), A. Mulè (1), A. Marrazzo (3), C. La Cascia (1,2), D. La Barbera (1,2)

1 University Hospital “Paolo Giaccone”, Unit of Psychiatry, Palermo, Italy; 2 Department of Experimental Biomedicine and Clinical Neuroscience (BioNec), Section of Psychiatry, University of Palermo, Italy; 3 Department of Experimental Oncology and Clinical Application (DOSAC), University of Palermo, Italy


The aim of this study was to evaluate the effect of alexithymia and defence mechanisms on the quality of life of patients affected by breast cancer at different stages of the disease.


A convenience sample of 110 patients with breast cancer was involved in the study: 41 were receiving adjuvant chemotherapy after surgery, 29 had disease-free survival in follow-up and 40 were receiving chemotherapy for metastatic disease. Quality of life, alexithymia and defence mechanisms were assessed using the following instruments: EORTC QLQ-C30-BR23, Toronto Alexithymia Scale (TAS-20) and Defense Mechanism Inventory (DMI). 


Compared to the other groups, patients receiving chemotherapy for metastatic disease reported poorer quality of life in several domains, more severe cancer-related and treatment-related symptoms and higher levels of alexithymia. When the effect of other potential predictors was taken into account, TAS-20 difficulty in identifying feelings was significantly related to all the EORTC functional subscale. 


This study underlined the relevance of difficulty in emotional processing and defence mechanisms in modulating psychological adjustment in women affected by breast cancer, suggesting that these might be potential targets of psychological intervention for this population.

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