Background: Although the alexithymia construct was derived from observations of patients with classical psychosomatic diseases, empirical studies have found only a moderate association between alexithymia and inflammatory bowel disease (IBD). Indeed, there is some evidence that alexithymia may be associated more strongly with functional somatic symptoms than with the psychosomatic diseases. The present study examined the relationship between alexithymia and functional gastrointestinal disorders (FGIDs) in a group of 121 FGID patients, and compared the results with findings from a group of 116 IBD patients and a group of 112 healthy subjects. Method: The subjects completed the 20-item Toronto Alexithymia Scale and the Hospital Anxiety and Depression Scale. Results: The FGID group was significantly more alexithymic than the IBD group, and the two gastrointestinal groups were more alexithymic than the normal healthy group. These differences remained even after controlling for the influence of education, gender, anxiety, depression and gastrointestinal symptoms. Conclusions: The finding of a high rate of alexithymia (66%) in the group of FGID patients is consistent with the propensity of these patients to somatization and to high levels of poorly differentiated psychological distress.

Nemiah JC, Sifneos PE: Affect and fantasy in patients with psychosomatic disorders; in Hill OW (ed): Modern Trends in Psychosomatic Medicine. London, Butterworths, 1970, vol 2, pp 26–34.
Nemiah JC, Freyberger H, Sifneos PE: Alexithymia: A view of the psychosomatic process; in Hill OW (ed): Modern Trends in Psychosomatic Medicine. London, Butterworths, 1976, vol 3, pp 430–439.
Taylor GJ, Bagby RM, Parker JDA: Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Cambridge, Cambridge University Press, 1997.
Alexander F, French TM, Pollock GH: Psychosomatic specificity. Chicago, Chicago University Press, 1968, vol 1.
Engel GL: Studies of ulcerative colitis. III. The nature of the psychologic processes. Am J Med 1955;17:231–256.
Sammons MT, Karoly P: Psychosocial variables in irritable bowel syndrome: A review and proposal. Clin Psychol Rev 1977;7:187–206.
Toner BB, Garfinkel PE, Jeejeebhoy KN: Psychological factors in irritable bowel syndrome. Can J Psychiatry 1990;35:158–161.
Taylor GJ, Doody K, Newman A: Alexithymic characteristics in patients with inflammatory bowel disease. Can J Psychiatry 1981;26:470–474.
Fava GA, Pavan L: Large bowel disorders. II. Psychopathology and alexithymia. Psychother Psychosom 1976/77;27:100–105.
Nakagawa T, Sugita M, Nakai Y, Ikemi Y: Alexithymic features in digestive diseases. Psychother Psychosom 1979;32:191–203.
Bagby RM, Parker JDA, Taylor GJ: The twenty-item Toronto Alexithymia Scale. I. Item selection and cross-validation of the factor structure. J Psychosom Res 1994;38:23–32.
Bagby RM, Parker JDA, Taylor GJ: The twenty-item Toronto Alexithymia Scale. II. Convergent, discriminant, and concurrent validity. J Psychosom Res 1994;38:33–40.
Porcelli P, Zaka S, Leoci C, Centonze S, Taylor GJ: Alexithymia in inflammatory bowel disease. Psychother Psychosom 1995;64:49–53.
Porcelli P, Leoci C, Guerra V, Taylor GJ, Bagby RM: A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease. J Psychosom Res 1996;41:569–573.
Heaton KW: Irritable bowel syndrome; Still in search of its identity. Br Med J 1983;287:852–853.
Whorwell PJ: Irritable mind. Lancet 1984;ii:1249–1250.
Weiner H: Specificity and specification: Two continuing problems in psychosomatic research. Psychosom Med 1992;54:567–587.
Drossman DA (ed): The Functional Gastrointestinal Disorders: Diagnosis, Pathophysiology, and Treatment. Boston, Little, Brown and Company, 1994.
Kellner R: Psychosomatic Syndromes and Somatic Symptoms. Washington, American Psychiatric Press, 1991.
Mayou R: Somatization. Psychother Psychosom 1993;59:69–83.
Kutscher S-U, Holtmann G, Heuft G, Senf W, Goebell H: Somatization in functional dyspepsia and irritable bowel syndrome: A short review; in Goebell H, Holtmann G (eds): Functional Dyspepsia and Irritable Bowel Syndrome: Concepts and Controversies. Dordrecht, Kluwer, 1998.
Walker EA, Gelfand AN, Gelfand MD, Katon WJ: Psychiatric diagnoses, sexual and physical victimization, and disability in patients with irritable bowel syndrome or inflammatory bowel disease. Psychol Med 1995;25:1259–1267.
Chey WY: Functional Disorders of the Digestive Tract. New York, Raven Press, 1983.
Drossman DA, McKee DC, Sandler RS, Mitchell CM, Cramer EM, Lowman BC, Burger AL: Psychosocial factors in the irritable bowel syndrome: A multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology 1988;95:701–708.
Whitehead WE, Bosmajian L, Zonderman AB, Costa PT, Schuster MM: Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples. Gastroenterology 1988;95:709–714.
Walker EA, Roy-Byrne PP, Katon WJ, Li L, Amos D, Jiranek G: Psychiatric illness and irritable bowel syndrome: A comparison with inflammatory bowel disease. Am J Psychiatry 1990;147:1656–1661.
Agreus L, Svardsudd K, Nyren O, Tibblin G: Irritable bowel syndrome and dyspepsia in the general population: Overlap and lack of stability over time. Gastroenterology 1995;109:671–680.
Bressi C, Taylor GJ, Parker JDA, Bressi G, Brambilla V, Aguglia E, Allegranti I, Bongiorno A, Giberti F, Bucca M, Todarello O, Callegari C, Vender S, Gala C, Invernizzi G: Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: An Italian multicenter study. J Psychosom Res 1996;41:551–559.
Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361–370.
Herrmann C: International experiences with the Hospital Anxiety and Depression Scale – A review of validation data and clinical results. J Psychosom Res 1997;42:17–41.
Naifeh KH: Psychometric testing in functional GI disorders; in Olden KW (ed): Handbook of Functional Gastrointestinal Disorders. New York, Marcel Dekker, 1996, pp 79–126.
Truelove SC, Witts LJ: Cortisone in ulcerative colitis. Preliminary report on a therapeutic trial. Br Med J 1954;2:375–378.
Harvey RF, Bradshaw JM: A simple index of Crohn’s disease activity. Lancet 1980;i:514.
Todarello O, Taylor GJ, Parker JDA, Fanelli M: Alexithymia in essential hypertension and psychiatric outpatients: A comparative study. J Psychosom Res 1995;39:987–994.
North CS, Clouse RE, Spitznagel EL, Alpers DH: The relation of ulcerative colitis to psychiatric factors: A review of findings and methods. Am J Psychiatry 1990;147:974–981.
Bagby RM, Taylor GJ, Parker JDA: Construct validity of the Toronto Alexithymia Scale. Psychother Psychosom 1988;50:29–34.
Kauhanen J, Julkunen J, Salonen JT: Alexithymia and perceived symptoms: Criterion validity of the Toronto Alexithymia Scale. Psychother Psychosom 1991;56:247–252.
Taylor GJ, Parker JDA, Bagby RM, Acklin MW: Alexithymia and somatic complaints in psychiatric outpatients. J Psychosom Res 1992;36:417–424.
Cox BJ, Kuch K, Parker JDA, Shulman ID, Evans RJ: Alexithymia in somatoform disorder patients with chronic pain. J Psychosom Res 1994;38:523–527.
Bach M, Bach D: Alexithymia in somatoform disorders and somatic diseases: A comparative study. Psychother Psychosom 1996;65:150–152.
Wise TN, Mann LS, Shay L: Alexithymia and the five-factor model of personality. Compr Psychiatry 1992;33:147–151.
Zeitlin SB, McNally RJ: Alexithymia and anxiety sensitivity in panic disorder and obsessive-compulsive disorder. Am J Psychiatry 1993;150:658–660.
Zeitlin SB, Lane RD, O’Leary DS, Schrift MJ: Interhemispheric transfer deficit and alexithymia. Am J Psychiatry 1989;146:1434–1439.
Taylor GJ, Parker JDA, Bagby RM: A preliminary investigation of alexithymia in men with psychoactive substance dependence. Am J Psychiatry 1990;147:1228–1230.
Bourke MP, Taylor GJ, Parker JDA, Bagby RM: Alexithymia in women with anorexia nervosa: A preliminary investigation. Br J Psychiatry 1992;161:240–243.
Maunder RG: Panic disorder associated with gastrointestinal disease: Review and hypotheses. J Psychosom Res 1998;44:91–105.
Bennett EJ, Piesse C, Palmer K, Badcock C-A, Tennant CC, Kellow JE: Functional gastrointestinal disorders: Psychological, social and somatic features. Gut 1998;42:414–420.
Parker JDA, Taylor GJ: Alexithymia and emotional intelligence. Paper presented at the Annual Convention of the American Psychological Association, San Francisco 1998.
Parker JDA, Taylor GJ, Bagby RM: Alexithymia: Relationship with ego defense and coping styles. Compr Psychiatry 1998;39:91–98.
Lumley MA, Stettner L, Wehmer F: How are alexithymia and physical illness linked? A review and critique of pathways. J Psychosom Res 1996;41:505–518.
Wise TN, Mann LS: The relationship between somatosensory amplification, alexithymia, and neuroticism. J Psychosom Res 1994;38:515–521.
Trimble KC, Farouk R, Pryde A, Douglas S, Heading RC: Heightened visceral sensation in functional gastrointestinal disease is nonsite-specific. Evidence for a generalized disorder of gut sensitivity. Dig Dis Sci 1995;40:1607–1613.
Blanchard EB, Scharff L, Schwartz SP, Suls JM, Barlow DH: The role of anxiety and depression in the irritable bowel syndrome. Behav Res Ther 1990;28:401–405.
Drossman DA, Thompson WG: Irritable bowel syndrome: A graduated, multicomponent treatment approach. Ann Intern Med 1992;116:1009–1016.
Gick ML, Thompson WG: Negative affect and the seeking of medical care in university students with irritable bowel syndrome: A preliminary study. J Psychosom Res 1997;43:535–540.
Taub E, Cook E, Burnett C, Morris R, Perkins M, Tanner D, Noell R, Hanna B, Brown M, Whitehead WE: Irritable bowel syndrome: Do physical symptoms or psychological symptoms determine who consults a physician. Am J Gastroenterology 1994;89:1700.
Lumley MA, Tomakowsky J, Torosian T: The relationship of alexithymia to subjective and biomedical measures of disease. Psychosomatics 1997;38:497–502.
Lumley MA, Norman S: Alexithymia and health care utilization. Psychosom Med 1996;58:197–202.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.