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

• Published in: General hospital psychiatry 2013-09, Vol.35 (5), p.521-527
• Main Authors: Porcelli, Piero, Ph.D, Guidi, Jenny, Ph.D, Sirri, Laura, Ph.D, Grandi, Silvana, M.D, Grassi, Luigi, M.D, Ottolini, Fedra, Ph.D, Pasquini, Paolo, M.D, Picardi, Angelo, M.D, Rafanelli, Chiara, M.D., Ph.D, Rigatelli, Marco, M.D, Sonino, Nicoletta, M.D, Fava, Giovanni Andrea, M.D
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Affective Symptoms - epidemiology; Alexithymia; Anxiety Disorders - epidemiology; Biological and medical sciences; Cluster analysis; Comorbidity; Diagnostic Criteria for Psychosomatic Research; Female; Gastrointestinal Diseases - psychology; Heart Diseases - psychology; Humans; Illness behavior; Interview, Psychological; Male; Medical sciences; Middle Aged; Mood Disorders - epidemiology; Neoplasms - psychology; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Skin Diseases - psychology; Somatization; Somatoform Disorders - epidemiology; Somatoform disorders. Psychosomatics
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2013.04.005

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.