Alexisomia, Depression, and Adherence in Kidney Transplantation: A Preliminary Investigation

Background: Sustained immunosuppressive adherence is essential for long-term graft survival in kidney transplant recipients. While depression and alexithymia have been linked to nonadherence, the role of alexisomia—impaired awareness of bodily signals—remains unclear. This study examined the association between alexisomia, depressive symptoms, and treatment adherence in this population. Methods: This cross-sectional study included 82 adult kidney transplant recipients with stable graft function. Treatment adherence was assessed using the Immunosuppressant Therapy Adherence Scale (ITAS). Emotional and psychosomatic traits were evaluated with the Toronto Alexithymia Scale (TAS-20), the Alexisomia Scale, and the Hospital Anxiety and Depression Scale (HADS). Patients were stratified into good vs poor adherence groups based on ITAS scores. A p-value <0.05 was considered statistically significant. Results: A total of 82 patients were included (52 with poor adherence, 30 with good adherence). The groups were similar in baseline characteristics. Alexisomia total and HADS-depression scores were significantly higher in the poor adherence group. Total TAS scores were also higher, but not statistically significant. Among alexithymia subscales, only difficulty in describing bodily emotions differed significantly. No significant differences were found in other areas of interest (Table 1). Conclusion: This preliminary study suggests that higher levels of alexisomia and depressive symptoms may be associated with nonadherence in kidney transplant recipients. Among alexithymia subdimensions, only difficulty in describing bodily emotions differed significantly, which supports the rationale to move beyond general emotional measures and consider somatic-emotional processing in adherence research. Alexisomia may be a relevant but underrecognized factor in nonadherence after kidney transplantation. Larger studies with multivariate analyses are needed to clarify its role and clinical utility.