The role of alexithymia and gastrointestinal-specific anxiety as predictors of treatment outcome in irritable bowel syndrome

Piero Porcelli, Massimo De Carne, Gioacchino Leandro

Research output: Contribution to journalArticlepeer-review

Abstract

In a previous investigation irritable bowel syndrome (IBS) was associated more to alexithymia than gastrointestinal-specific anxiety (GSA). In this study their independent contribution in predicting treatment outcome was longitudinally investigated. Consecutive 150 IBS patients were evaluated for IBS symptoms, alexithymia, GSA, and psychological distress with validated scales after as-usual treatment for 6-12months. The primary treatment outcome was improvement measured with the IBS-Severity Scoring System that showed 111 patients who improved and 39 who did not improve. Improvement was associated to both alexithymia (d=1.27) and GSA (d=4.63) but only alexithymia showed overtime stability by hierarchical regression, controlled for co-variables. A series of logistic and linear regressions showed that baseline alexithymia, but not GSA, independently predicted both post-treatment improvement status (Cox & Snell R(2)=0.15; overall classification rate=74%) and symptom change (23% of explained variance). Although alexithymia and GSA were closely related IBS symptoms, only alexithymia was found to be a stable trait and a stronger predictor of treatment outcome than GSA. Since no treatment was established to be definitely effective for IBS, clinicians might improve treatment outcome by identifying patients with high alexithymia, attempting to improve their coping skills, emotional regulation, and affective awareness.

Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalComprehensive Psychiatry
Volume73
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Adolescent
  • Adult
  • Affective Symptoms
  • Aged
  • Anxiety
  • Depression
  • Female
  • Humans
  • Irritable Bowel Syndrome
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Regression Analysis
  • Risk Factors
  • Treatment Outcome
  • Young Adult
  • Journal Article
  • Observational Study

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