28 MED ARH. 2012; 66(1): 28-32 • ORIgINAL PAPER
Alexithymia and Functional gastrointestinal Disorders (FgID)
MED ARH. 2012; 66(1): 28-32
ORIGINAL PAPER
Alexithymia and Functional Gastrointestinal
Disorders (FGID)
Mina Mazaheri
1
, Hamid Afshar
1
, Stephan Weinland
2
, Narges Mohammadi
1
, Peyman Adibi
3
Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
1
School of Medicine, University of North Carolina (UNC), USA
2
Integrative Functional gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3
I
ntroduction: he purpose of this study was to examine alexithymia
symptoms, demographic variables and the severity of gastrointestinal
symptoms in a sample of patients with functional gastrointestinal dis-
orders (FGID) and a comparative sample of healthy controls. Materials
and Methods: he sample consisted of 237 individuals, 129 of whom were
patients diagnosed with FGIDs. he patients referred to the psychosomatic
disorders clinic of Nour Hospital, Isfahan, Iran. he controlled group in-
cluded 108 healthy individuals (without digestive diagnosis) matched with
the patients by age, gender, marital and educational status. he Toronto
Alexithymia Scale (TAS-20) and the Gastrointestinal Symptoms Rating
Scale (GSRS) were used to collect data. Data was analyzed using multivari-
ate analysis of variance (MANOVA), correlation coeicients and Fisher’s z.
Results: here was a signiicant diference between patients with FGIDs and
healthy controls in terms of number of alexithymia symptoms and severity
of gastrointestinal symptoms. he results also indicated the existence of a
relationship between educational level and alexithymia as well as its dimen-
sions (diiculty identifying feelings and diiculty describing feelings) in
both groups. However, no signiicant diferences were found between the
two groups in this regard. Conclusion: he indings of this study indicated
that compared to the healthy control group, patients with FGIDs had higher
scores of alexithymia and more severe somatic symptoms. Furthermore,
higher educational levels were associated with decreased risk of alexithymia.
Such inding might be due to higher ability to describe and identify emotions
in patients with higher levels of education. Key words: Alexithymia, Functional
Gastrointestinal Disorders, Demographic Variables.
Corresponding author: Hamid Afshar. Telephone: +98 913 325 2576. Email: afshar@med.mui.ac.ir
1. INTRODUCTION
Alexithymia is defined as a de-
creased ability to use language in the
expression of emotion (1). Bagby et al.
proposed alexithymia to be a multidi-
mensional construct with features (di-
mensions) including di iculty in de-
scribing feelings, di iculty in distin-
guishing feelings and bodily sensations,
inability to communicate with others,
lack of dreams and imaginary life, and
focusing on external experiences (2).
hese features are thought to show de-
iciencies in the cognitive processing
and regulation of emotions (3), and may
be important risk factors in developing
some psychosomatic disorders (4).
In recent years, alexithymia has
motivated the study of neurobiology of
emotion and how it may relate to unex-
plained physical symptoms (5). Patients
with alexithymia symptoms appear to
amplify normal body sensations and
interpret somatic signs of emotional
arousal poorly (6).
Although the alexithymia construct
was derived from the classical psycho-
somatic disease (1), Taylor et al. be-
lieved that alexithymia might appear
more frequently with functional so-
matic symptoms than with the classi-
cal psychosomatic diseases (7). A study
by Porcelli et al. indicated that patients
with functional gastrointestinal disor-
ders (FGIDs) were signi icantly more
alexithymic than inlammatory bowel
disease (IBD) patients and healthy per-
sons. It was reported that 66% of the pa-
tients with FGIDs demonstrated alex-
ithymic symptoms.
FGIDs are the most common gastro-
intestinal (GI) problems (9). Although
the pathophysiology of FGIDs is not
fully understood, evidence has shown
that factors including psychological dis-
tress and personality disturbances may
predicate symptom development (9).
Studying patients with irritable bowel
syndrome (IBS) has revealed these pa-
tients to have greater diiculty in iden-
tifying and expressing feelings and also
in daydreaming compared to healthy
persons (10). Drossman et al. proposed
personality traits and emotional states
to possibly inluence the physiology of
the gut, FGID symptom experience, and
the outcome of treatment (9). Kano et al.
demonstrated an association between
alexithymia and hypersensitivity to vis-
ceral stimulation. his inding conirms
doi: 10.5455/medarh.2012.66.28-32
Recieved: November 18th 2011
Accepted: January 10th 2012
© Avicena 2012