title: Psychosomatic syndromes and anorexia nervosa.
abstract: BACKGROUND
  In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR) to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients.
  
  
  METHODS
  108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP) were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory-2, and Temperament and Character Inventory. Data were submitted to cluster analysis.
  
  
  RESULTS
  Illness denial (63%) and alexithymia (54.6%) resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%), somatization group (26%), and severe psychosomatic group (25%). The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome.
  
  
  CONCLUSIONS
  These results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments.
authors.affiliation: Department of Neuroscience, Section of Psychiatry, Eating Disorders Centre, University of Turin, Turin, Italy. giovanni.abbatedaga@unito.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbate-Daga
authors.forename: Nadia
authors.initials: N
authors.lastname: Delsedime
authors.forename: Barbara
authors.initials: B
authors.lastname: Nicotra
authors.forename: Cristina
authors.initials: C
authors.lastname: Giovannone
authors.forename: Enrica
authors.initials: E
authors.lastname: Marzola
authors.forename: Federico
authors.initials: F
authors.lastname: Amianto
authors.forename: Secondo
authors.initials: S
authors.lastname: Fassino
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002605:Character; D015897:Comorbidity; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D010555:Personality Inventory; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013694:Temperament