Alexithymia and psychopathology in patients with psychiatric and functional gastrointestinal disorders.
BACKGROUND
Alexithymia and psychopathology may influence the way individuals experience psychological distress and somatic symptoms. This study evaluated patients referred to psychiatric and gastroenterologic outpatient settings in order to investigate the levels of alexithymia and psychopathology, and the possible role of alexithymia in symptom perception and health care utilization. The association between psychiatric disorders and functional gastrointestinal disorders (FGIDs) was also assessed.


METHODS
Psychopathology (by the Revised 90-item Symptom Checklist), alexithymia (by the 20-item Toronto Alexithymia Scale), and gastrointestinal symptoms (by the Gastrointestinal Symptom Rating Scale) were evaluated in 52 psychiatric outpatients and 58 medical outpatients with FGIDs. Two comorbid subgroups of 25 psychiatric patients with FGIDs and 38 FGID patients with psychiatric disorders were formed and compared.


RESULTS
Forty-eight percent of the psychiatric patients had associated FGIDs, and 65.5% of the FGID patients had associated psychiatric disorders. The FGID patients had significantly less psychopathology, but significantly higher alexithymia and more severe gastrointestinal symptoms, than the psychiatric patients. In the comparison of the two subgroups with comorbidity, FGID patients with psychiatric disorders were still more alexithymic and had less psychopathology than psychiatric patients with FGIDs, but gastrointestinal symptoms were not significantly different.


CONCLUSIONS
Patients with 'functional' gastrointestinal symptoms attending a medical care service are likely to be highly alexithymic, whereas those attending a psychiatric care service are likely to show severe psychopathology. Alexithymia seems to influence the presentation of 'functional' somatic symptoms and the type of health care utilization.
Porcelli
Piero
P
Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Italy. porcellip@mail.media.it
Affatati
Valeria
V
Bellomo
Antonello
A
De Carne
Massimo
M
Todarello
Orlando
O
Taylor
Graeme J
GJ
D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000523:psychology*; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales