Objective: Even though the association between alexithymia and somatization seems plausible according to several studies with selected populations, it has not been verified in carefully controlled and nationally representative population studies. We conducted such a study to find out whether alexithymia is associated with somatization at population level. Methods: This study was a part of the Finnish Health 2000 Study. The nationally representative sample comprised 5129 subjects aged 30 to 97 years. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and somatic symptom reporting with the 12-item somatization scale derived from the Hopkins Symptom Checklist. Sociodemographic and health-related variables, including depressive and anxiety disorders, and physician verified somatic diagnoses, were treated as confounders in multivariate analyses. Results: Alexithymia was associated with somatization independently of somatic diseases, depression and anxiety and confounding sociodemographic variables. The TAS-20 factor scale “Difficulties Identifying Feelings” was the strongest common denominator between alexithymia and somatization. Conclusions: This was the first time the independent association between alexithymia and somatization was established in a large, nationally representative nonclinical sample of both young and old adults with and without mental disorders and somatic diseases. TAS-20 = 20-item version of the Toronto Alexithymia Scale; DIF = difficulties identifying feelings; DDF = difficulties describing feelings; EOT = externally orientated thinking; SCL-90 = Hopkins Symptom Checklist; SCL SOM = 12-item somatization scale derived from SCL-90; M-CIDI = Munich version of the Composite International Diagnostic Interview; ICD-10 = International Statistical Classification of Diseases and Related Health Problems, 10th Revision; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; SEM = structural equation modeling.

Home blood pressure (BP) measurement has allowed the identification of individuals with normal office and elevated out-of-office BP (masked hypertension). It is, however, not feasible to measure home BP on all office normotensive individuals. The objective of the present study was to identify demographic, lifestyle, clinical and psychological characteristics suggestive of masked hypertension. Study population was drawn from the participants of a multidisciplinary epidemiological survey, the Health 2000 Study. The untreated nationwide population sample (n = 1459, age 45–74 years) underwent office (duplicate measurements on one visit) and home (duplicate measurements on 7 days) BP measurements and risk factor evaluation. Psychometric tests assessed psychological distress, hypochondriasis, depression and alexithymia. Masked hypertension was defined as normal office BP (<140/90 mmHg) with elevated home BP (≥135/85 mmHg). The prevalence of masked hypertension was 8.1% in the untreated Finnish adult population. The cardiovascular risk profile of masked hypertensive patients resembled that of sustained hypertensive patients. High-normal systolic and diastolic office BP, older age, greater BMI, current smoking, excessive alcohol consumption, diabetes and electrocardiographic left-ventricular hypertrophy were independent determinants of masked hypertension in multivariate logistic regression analysis. Masked hypertension was also independently associated with hypochondria. Masked hypertension is a common phenomenon in an untreated adult population. Physicians should consider home BP measurement if a patient has high-normal office BP, diabetes, left-ventricular hypertrophy, or several other conventional cardiovascular risk factors.

Sexual function and attitudes toward surgery were evaluated in females who had undergone feminizing genitoplasty in childhood. Sexual function and attitudes toward surgery were assessed by a questionnaire in 24 females who had undergone genitoplasty in childhood. Of 16 females who were prenatally exposed to androgens 15 had congenital adrenal hyperplasia and 8 had androgen insensitivity. A total of 18 patients who had reached adulthood were compared with 900 age matched normal controls by using the Female Sexual Function Index questionnaire. Of the 24 patients 19 had undergone clitoral reduction and 21 had undergone reconstruction of the vaginal introitus. Sigmoid bowel had been used in vaginal reconstruction in 5 patients. There were 17 patients who believed that the genital operation was performed at a proper age, 3 who thought it was done too late while none thought it was performed at too young an age. Two patients regretted the operation, 1 of whom had undergone clitoral resection without nerve preservation and the other had a sigmoid vagina. The control group had more often and earlier (median age 17 vs 19 years) experiences with sexual intercourse. Overall sexual function was similar in the sexually active controls and patients. Decreased sexual desire and problems in achieving orgasm were common but severe pain experiences during penetrative sex were rare in both groups. Sexual intercoital relationships started later in females who underwent genital reconstruction in childhood. Early surgery is preferred by the patients and satisfactory sex life is possible in adulthood.