Alexithymia and personality traits of patients with inflammatory bowel disease

Abstract

Psychological factors, specific lifestyles and environmental stressors may influence etiopathogenesis and evolution of chronic diseases. We investigate the association between Chronic Inflammatory Bowel Diseases (IBD) and psychological dimensions such as personality traits, defence mechanisms, and Alexithymia, i.e. deficits of emotional awareness with inability to give a name to emotional states. We analyzed a survey of 100 patients with IBD and a control group of 66 healthy individuals. The survey involved filling out clinical and anamnestic forms and administering five psychological tests. These were then analyzed by using a network representation of the system by considering it as a bipartite network in which elements of one set are the 166 individuals, while the elements of the other set are the outcome of the survey. We then run an unsupervised community detection algorithm providing a partition of the 166 participants into clusters. That allowed us to determine a statistically significant association between psychological factors and IBD. We find clusters of patients characterized by high neuroticism, alexithymia, impulsivity and severe physical conditions and being of female gender. We therefore hypothesize that in a population of alexithymic patients, females are inclined to develop psychosomatic diseases like IBD while males might eventually develop behavioral disorders.

Alexithymia in Gastroenterology and Hepatology: A Systematic Review

“…Finally alexithymia (β = −0.27), emotional control (β = 0.26), education (β = −0.7), and socioeconomic index (β = −0.09),played a significant role in predicting levels of quality of life [ R 2 = 0.21; F (4, 57) = 3.69; p < 0.01]. Consistently, Boye et al ( 2008b ) and La Barbera et al ( 2017 ) examined 109 and 100 IBD patients, respectively, and found that high levels of alexithymia were associated with lower scores of physical, mental and social functions. Specifically, in patients with UC alexithymia negatively and significantly correlated with physical ( r = −0.33), mental ( r = −0.49), and social ( r = −0.30) components of health-related quality of life (Boye et al, 2008b ).…”

“…Seven studies on alexithymia with IBD patients had a cross-sectional design (Porcelli et al, 1995 ; Verissimo et al, 1998 , 2000 ; Boye et al, 2008a , b ; Iglesias-Rey et al, 2012 ; La Barbera et al, 2017 ), and only 4 were longitudinal (Porcelli et al, 1996 ; Porcelli and Meyer, 2002 ; Tibon et al, 2005 ; Porcelli and Mihura, 2010 ).…”

“…In line with the view of alexithymia as a personality dimension associated with affective dysregulation, several studies have found consistently that alexithymic traits negatively influence a series of clinical outcomes, that are strictly related to the subjective perception of health. Specifically, the following were the main results in this regard: (1) in patients with FGID (Arun, 1998 ; Jones et al, 2004 , 2006 ) and also in those with non-alcoholic liver disease (Blomhoff and Malt, 1995 ) higher scores of alexithymia were directly associated with higher levels of negative emotional traits such as neuroticism, rigidity, introversion, and perfectionism; (2) there was a significant relationship between alexithymia and depressive symptoms in patients with FGID and peptic ulcer (Faramarzi et al, 2014 ), as well as in those with HCV and cirrhosis (Rustgi et al, 2010 ; Nardelli et al, 2013 ; Murri et al, 2017 ); (3) alexithymia correlated significantly with insecure attachment relations in patients with IBD (Bengtsson et al, 2013 ) and gastroesophageal reflux disorder (Farinelli et al, 2007 ); (4) alexithymia was significantly associated with lower quality of life and impaired psychosocial functioning in patients with HCV (Cozzolongo et al, 2015 ) and liver carcinoma (Palmieri et al, 2013 ), IBD (Verissimo et al, 1998 ; Iglesias-Rey et al, 2012 ; La Barbera et al, 2017 ), and FGID as well (Portincasa et al, 2003 ; Van Oudenhove et al, 2011b ; Jones et al, 2013 ).…”

The Vagus Nerve in the Neuro-Immune Axis: Implications in the Pathology of the Gastrointestinal Tract

“…A perturbation of this interoception is observed in diseases of the digestive tract such as IBS but also IBD. Indeed, alexithymia ( 29 ) is observed in both of them ( 30 – 32 ).…”

Alexithymia and Psychopathology in Patients Suffering From Inflammatory Bowel Disease: Arising Differences and Correlations to Tailoring Therapeutic Strategies

“…The presence of somatic symptoms in the general population of alexithymic patients is well known and is basically associated to a worsening of painful syndromes ( 66 , 67 ) and also to a worse condition in the forms of functional intestinal syndromes ( 68 ). The presence of “difficulty in identifying emotions” and “externally-oriented thinking” are associated with a reduced quality of life with a high correlation to anxious and depressive symptoms, somatisations, and reduced social functioning ( 69 – 71 ). From our data, alexithymia is also associated with a broader extension of gastrointestinal involvement and to a longer duration of undiagnosed pathology, which, as already seen, are in turn associated with a greater symptomatological severity.…”