title: Alexithymia in the medically ill. Analysis of 1190 patients in gastroenterology, cardiology, oncology and dermatology.
abstract: OBJECTIVE
  To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria.
  
  
  METHODS
  Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis.
  
  
  RESULTS
  Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%).
  
  
  CONCLUSIONS
  The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seem to be deceptively similar since they share the same psychiatric and/or medical diagnosis.
authors.affiliation: Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Italy. Electronic address: piero.porcelli@irccsdebellis.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Porcelli
authors.forename: Jenny
authors.initials: J
authors.lastname: Guidi
authors.forename: Laura
authors.initials: L
authors.lastname: Sirri
authors.forename: Silvana
authors.initials: S
authors.lastname: Grandi
authors.forename: Luigi
authors.initials: L
authors.lastname: Grassi
authors.forename: Fedra
authors.initials: F
authors.lastname: Ottolini
authors.forename: Paolo
authors.initials: P
authors.lastname: Pasquini
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: Chiara
authors.initials: C
authors.lastname: Rafanelli
authors.forename: Marco
authors.initials: M
authors.lastname: Rigatelli
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Sonino
authors.forename: Giovanni Andrea
authors.initials: GA
authors.lastname: Fava
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005767:Gastrointestinal Diseases / Q000523:psychology*; D006331:Heart Diseases / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009369:Neoplasms / Q000523:psychology*; D015995:Prevalence; D012871:Skin Diseases / Q000523:psychology*; D013001:Somatoform Disorders / Q000453:epidemiology
keywords: Alexithymia; Cluster analysis; Diagnostic Criteria for Psychosomatic Research; Illness behavior; Somatization