Alexithymia and Functional Gastrointestinal Disorders

Porcelli, Piero; Taylor, Graeme J.; Bagby, R. Michael; Carne, Massimo De

doi:10.1159/000012342

Cited by 106 publications

(56 citation statements)

References 47 publications

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“…The inibition of emotional expression and particularly a life-long tendency to suppress anger have been found to involve an increased risk for a variety of health problems, both using alexithymia [24]or similar [25]psychological constructs. Alexithymia, as measured by a self-rating scale, was found to characterize also FGID [26]. There was a considerable overlap between alexithymia and psychiatric diagnoses (particularly mood and somatoform disorders), as one would expect from the literature [27, 28, 29, 30, 31].…”

Section: Discussionmentioning

confidence: 99%

Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Porcelli¹,

Carne²,

Fava

2000

Psychother Psychosom

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Background: Psychiatric assessment of somatization (the tendency to experience and communicate psychological distress in the form of physical symptoms and to seek medical help for them) currently rests on DSM criteria. An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators. The aim of this study was to compare these new criteria (Diagnostic Criteria for Psychosomatic Research, DCPR) with DSM-IV in a population where a high prevalence of psychosocial problems is expected (functional gastrointestinal disorders, FGID). Method: One hundred and ninety consecutive patients with FGID in a tertiary care center were assessed according to DSM-IV and DCPR criteria. Results: The number of the 12 DCPR diagnoses was almost double that of DSM diagnoses. Only 9% of the patients were not identified by DCPR criteria, whereas this occurred in 25% of patients using DSM criteria. While patients who were given a DSM diagnosis frequently had additional DCPR diagnoses, many patients with DCPR syndromes did not fulfill any DSM criteria. Four DCPR syndromes appared to be particularly frequent and accounted for almost three quarters of the total diagnoses (alexithymia, persistent somatization, functional symptoms secondary to a psychiatric disorder, demoralization). Conclusions: The joint use of DSM and DCPR criteria was found to improve the identification of psychological factors in FGID. The results may pave the way for changes in DSM classification of somatoform disorders.

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Section: Discussionmentioning

confidence: 99%

Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Porcelli¹,

Carne²,

Fava

2000

Psychother Psychosom

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“…Patients with alexithymia have difficulties in recognizing and verbalizing emotions, and their ability to regulate emotions and express them to others is usually reduced [44,45] . Numerous studies [46][47][48][49][50] have shown that IBD patients have higher scores for alexithymia than controls. In a study conducted by Jones et al [46] (2006), the scores of 74 IBS patients, 55 healthy control subjects, and 48 IBD patients were compared on the Toronto Alexithymia Scale.…”

Section: Psychiatric Therapy In Ibdmentioning

confidence: 99%

“…The results showed that IBS and IBD patients had higher scores on measures of alexithymia than the controls, but they did not differ from one another. In an epidemiological study, Porcelli et al [50] (1999) compared 121 functional gastrointestinal disorder patients, 116 IBD patients, and a group of 112 healthy subjects using the Toronto Alexithymia Scale. Their results showed that the FGID group was significantly more alexithymic than the IBD group, and the scores of the two gastrointestinal groups were higher than the normal healthy group.…”

Section: Psychiatric Therapy In Ibdmentioning

confidence: 99%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Inflammatory bowel disease; Psychiatry; Treatment; Personality traits; Depression; Anxiety Core tip: The involvement of a dysfunction of brain-gut interactions in the pathogenesis of inflammatory bowel disease (IBD) is represented by a dysfunction of the autonomic nervous system, an abnormal hypothalamicpituitary-adrenal axis and cholinergic anti-inflammatory pathway, a deleterious effect of stress and depression, an abnormal coupling of the prefrontal cortex-amygdaloid complex, and an abnormal relation between the microbiota and the brain as pro-inflammatory factors. New investigations have provided a critical link between forebrain changes and abdominal pain independent of active disease and drug treatment, providing a potential basis for an explanation of the psychological symptoms and brain influence in the pathogenesis of IBD.

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“…Numerous studies have shown that alexithymia is associated with a variety of medical and psychiatric disorders including substance use disorders (e.g., Haviland, Hendryx, Shaw, & Henry, 1994), eating disorders (e.g., Taylor, Parker, Bagby, & Bourke, 1996), posttraumatic stress disorder (e.g., Frewen, Lanius, Dozois, Neufeld, Pain, Hopper et al, 2008), somatisation disorders (e.g., De Gucht & Heiser, 2003), functional gastrointestinal disorders (Porcelli, Taylor, Bagby, & De Carne, 1999), and a subtype of depression characterised by more somatic-affective symptoms (Vanheule, Desmet, Verhaeghe, & Bogaerts, 2007) (for an overview see Taylor et al, 1997;Taylor, 2004). In most studies alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20; .…”

Section: Introductionmentioning

confidence: 99%

The Dutch Language Version of the Toronto Structured Interview for Alexithymia: Reliability, Factor Structure and Concurrent Validity

et al. 2013

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The aim of this study was to evaluate the psychometric properties of the Dutch version of the Toronto Structured Interview for Alexithymia (TSIA) in a clinical sample. The TSIA and the 20-item Toronto Alexithymia Scale (TAS-20) were administered to 85 psychiatric inpatients and to 76 medical outpatients with the symptom of tinnitus. Both internal and inter-rater reliability were acceptable. Confirmatory factor analyses supported the hierarchical, 4-factor structure with 4 lower-order factors nested within 2 higher-order latent factors, previously obtained with English, German, and Italian versions. Concurrent validity was supported by significant correlations between the TSIA and the TAS-20 total scores although there were some differences between the psychiatric subsample and the medical subsample. While further studies are needed to assess the convergent and discriminant validity of the TSIA, the results support its use as a measure of alexithymia.

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Alexithymia and Functional Gastrointestinal Disorders

Cited by 106 publications

References 47 publications

Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

The Dutch Language Version of the Toronto Structured Interview for Alexithymia: Reliability, Factor Structure and Concurrent Validity

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