title: Alexithymia and gastrointestinal-specific anxiety in moderate to severe irritable bowel syndrome.
abstract: OBJECTIVE
  Gastrointestinal-specific anxiety (GSA) and alexithymia are two psychological constructs that may contribute to severity of irritable bowel syndrome (IBS). We aimed to investigate their independent contribution in predicting the level of severity in a group of patients with moderate to severe IBS.
  
  
  METHODS
  A sample of 177 consecutive IBS patients (49.2% with moderate and 50.8% with severe IBS), diagnosed with Rome III criteria, were evaluated for IBS symptoms, alexithymia, GSA, psychological distress, and psychosocial functioning with validated scales.
  
  
  RESULTS
  IBS severity was highly associated to both alexithymia (r=0.61) and GSA (r=0.66), that were also associated to each other (r=0.64). Severe IBS patients scored significantly different than moderate IBS patients to all scales in the expected direction. Multiple and hierarchical regression analyses showed that IBS severity was predicted at a similar degree by alexithymia and GSA, controlled for IBS symptoms, psychological distress, and psychosocial functioning. Effect sizes showed that the highest IBS severity scores were obtained by patients with high alexithymia alone (d=1.16) or combined with higher GSA (d=1.45).
  
  
  CONCLUSIONS
  Alexithymia and GSA were closely related to each other and associated to IBS severity, thus suggesting a common basis of emotional dysregulation. However, alexithymia (particularly the facets of difficulty identifying and describing feelings) resulted to be a stronger predictor of IBS severity than GSA, thus suggesting that impaired affective awareness may reflect on the clinical manifestations of IBS.
authors.affiliation: Psychosomatic Unit, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Italy. Electronic address: piero.porcelli@irccsdebellis.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Porcelli
authors.affiliation: Department of Gastroenterology 2, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Carne
authors.affiliation: Department of Gastroenterology 1, Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital, Castellana Grotte, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Leandro
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000342:Affective Symptoms / Q000150:complications*; D000368:Aged; D001007:Anxiety / Q000150:complications*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications; D055815:Young Adult