Alexithymia in the medically ill. Analysis of 1190 patients in gastroenterology, cardiology, oncology and dermatology

Piero Porcelli, Jenny Guidi, Laura Sirri, Silvana Grandi, Luigi Grassi, Fedra Ottolini, Paolo Pasquini, Angelo Picardi, Chiara Rafanelli, Marco Rigatelli, Nicoletta Sonino, Giovanni Andrea Fava

Research output: Contribution to journalArticlepeer-review

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. Method: 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.

Original languageEnglish
Pages (from-to)521-527
Number of pages7
JournalGeneral Hospital Psychiatry
Volume35
Issue number5
DOIs
Publication statusPublished - Sep 2013

Keywords

  • Alexithymia
  • Cluster analysis
  • Diagnostic Criteria for Psychosomatic Research
  • Illness behavior
  • Somatization

ASJC Scopus subject areas

  • Psychiatry and Mental health

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