title: The influence of alexithymia on persistent symptoms of dyspepsia after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  The aim of this study was to evaluate whether preoperative alexithymia might play a role in the persistence of gastrointestinal symptoms after laparoscopic cholecystectomy.
  
  
  METHODS
  A sample of 52 consecutive patients with gallstone disease and symptoms of dyspepsia were assessed with validated scales for alexithymia (20-item Toronto Alexithymia Scale), and psychological (90-item Symptom Checklist) and gastrointestinal (GI) (Gastrointestinal Symptom Rating Scale) symptoms before surgery. GI symptoms were evaluated also one year after surgery. Change from preoperative to postoperative GI symptoms and level of GI symptoms after surgery were used to form groups of improved (n = 31) and unimproved (n = 21) patients.
  
  
  RESULTS
  Unimproved patients had significantly higher preoperative alexithymia, psychological distress, and gastrointestinal symptom scores than patients who had improved. Regression analyses showed that alexithymia predicted the persistence of gastrointestinal symptoms more strongly than did psychological distress, even after controlling for preoperative gastrointestinal symptoms.
  
  
  CONCLUSIONS
  Alexithymia played a substantial and predictive role in the persistence of GI symptoms in gallstone patients after surgery. Treatment planning and outcome of gallstone disease might be improved by preoperative assessment of alexithymia.
authors.affiliation: Unità di Psicosomatica, IRCCS De Bellis Hospital, Castellana Grotte, Bari, Italy. porcellip@media.it
authors.forename: Piero
authors.initials: P
authors.lastname: Porcelli
authors.forename: Dionigi
authors.initials: D
authors.lastname: Lorusso
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Taylor
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000523:psychology* / Q000534:rehabilitation*; D015897:Comorbidity; D004415:Dyspepsia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D042882:Gallstones / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011184:Postoperative Period; D011300:Preoperative Care; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome