The role of psychiatric symptoms, alexithymia, and maladaptive defenses in patients with functional dyspepsia

Faramarzi, Mahbobeh; Shokri‐Shirvani, Javad; Kheirkhah, Farzan

doi:10.4103/0019-5359.110865

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…When considered categorically by using the suggested TAS-20 cut-off scores (Taylor et al, 1997 ), the prevalence of alexithymia was 66% ( n = 80) in the FGID, 38% ( n = 44) in the IBD, and 4.5% ( n = 5) in the control groups (χ 2 = 94.94, p < 0.001). Similarly, it was found that 60 FD patients scored significantly higher than 60 controls on the total (61.58 ± 6.56 vs. 47.50 ± 8.30) as well as the DIF (27.45 ± 4.31 vs. 17.52 ± 4.47) and DDF (17.22 ± 4.10 vs. 13.00 ± 3.74) subscales, even after multiple adjustments ( F = 106.16; p < 0.001) (Faramarzi et al, 2012 ). By contrast, there was no statistically significant difference between groups on the EOT factor of the TAS (16.92 ± 3.51 vs. 16.98 ± 3.31; t -test; p = 0.915).…”

Section: Resultsmentioning

confidence: 98%

“…Most studies on FGID had a cross-sectional design (Arun, 1998 ; Porcelli et al, 1999 ; Porcelli and De Carne, 2001 ; Weinryb et al, 2003 ; Van Oudenhove et al, 2008 ; Van Oundenhove et al, 2011a ; Faramarzi et al, 2012 ; Mazaheri et al, 2012 ; Bengtsson et al, 2013 ) and control groups were formed of healthy subjects (Arun, 1998 ; Porcelli et al, 1999 ; Faramarzi et al, 2012 ; Mazaheri et al, 2012 ). The first study investigating alexithymia with the original TAS-26 (Taylor et al, 1985 ) in a sample of 30 IBS patients showed they had higher levels of alexithymia (125.96 ± 11.5) than a control group of 30 matched healthy subjects (108.96 ± 13.29) ( t = 20.04; p < 0.01) (Arun, 1998 ).…”

Section: Resultsmentioning

confidence: 99%

“…Even with some limitations in mind, the assessment of alexithymia in these patients during all stages of patient management, from diagnosis to treatment outcome, is recommended by using the TAS-20 in combination with several validated instruments (self-report scales, interviews, and personality tests), according to the clinical and research needs. Also, since some intervention trials showed that reducing alexithymia significantly contribute to ameliorate symptoms in patients with cancer-related pain (Tulipani et al, 2010 ), FGID (Faramarzi et al, 2012 ; Porcelli et al, 2017 ), and multisomatoform symptoms (Probst et al, 2017 ), clinicians are strongly suggested to treat alexithymia as a solid contribution to improve the clinical condition of their patients. Even if not directly associated with positive symptom change, reduction of alexithymia may greatly improve the capacity to recognize one's feelings and to communicate them to others, thus contributing to positive clinical outcomes by enhancing psychosocial functioning, affective regulation (Cameron et al, 2014 ), and psychological well-being.…”

Section: Discussionmentioning

confidence: 99%

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Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Carrozzino

Porcelli

2018

Front. Psychol.

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Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation.Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies.Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies (n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10–15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample sizes, patients referred to secondary and tertiary care centers, cross-sectional study design, use of one single scale for alexithymia) constitutes a limitation to the generalization of findings.Conclusions: Alexithymia showed to play different roles in gastroenterology according to the clinical characteristics and the psychological burden of the various disorders, with main relevance in increasing subjective symptom perception and affecting negatively post-treatment outcomes.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Carrozzino

Porcelli

2018

Front. Psychol.

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“…It refers to a personality trait associated with difficulties with identifying or describing feelings, mental imaging and fantasy, and external cognitive orientation [1]. Research has revealed that alexithymia is associated with psychiatric disorders, such as psychosomatic disorders [2–4], depression [5], and anxiety [6]. Some studies have reported a positive relationship between alexithymia and pain disorders [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Role of Alexithymia, Anxiety, and Depression in Predicting Self-Efficacy in Academic Students

Faramarzi

Khafri

2017

The Scientific World Journal

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Objective. Little research is available on the predictive factors of self-efficacy in college students. The aim of the present study is to examine the role of alexithymia, anxiety, and depression in predicting self-efficacy in academic students. Design. In a cross-sectional study, a total of 133 students at Babol University of Medical Sciences (Medicine, Dentistry, and Paramedicine) participated in the study between 2014 and 2015. All participants completed the Toronto Alexithymia Scale (TAS-20), College Academic Self-Efficacy Scale (CASES), and 14 items on anxiety and depression derived from the 28 items of the General Health Questionnaire (28-GHQ). Results. Pearson correlation coefficients revealed negative significant relationships between alexithymia and the three subscales with student self-efficacy. There was no significant correlation between anxiety/depression symptoms and student self-efficacy. A backward multiple regression analysis revealed that alexithymia was a negative significant predictor of self-efficacy in academic students (B = −0.512, P < 0.001). The prevalence of alexithymia was 21.8% in students. Multiple backward logistic analysis regression revealed that number of passed semesters, gender, mother's education, father's education, and doctoral level did not accurately predict alexithymia in college students. Conclusion. As alexithymia is prevalent in college students and affects self-efficacy and academic functioning, we suggest it should be routinely evaluated by mental physicians at universities.

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Evaluation of depression, anxiety, alexithymia, attachment, social support and somatization in functional dyspepsia

Kani

Dural

Kani

et al. 2018

Psychiatry and Clinical Psychopharmacology

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AIM: The psychiatric and psychosocial aetiology of Functional dyspepsia is not well known. In the present study, our aim is to determine the relative contributions of psychiatric predictorsi.e. depression, anxiety, somatization, alexithymiain relation with socio-psychological factors, specifically their personal characteristics (i.e. emotional attachment) and perceived social support, in distinguishing FD from organic dyspepsia and healthy samples. MATERIAL AND METHODS: An estimated 30 functional dyspepsia, 29 organic dyspepsia patients who were admitted to our gastroenterology outpatient clinic and 27 healthy controls were enrolled to our study. Beck Depression Inventory, Toronto Alexithymia Scale, Adult Attachment Scale, State-Trait Anxiety Inventory, Multidimensional Scale of Perceived Social Support and somatization sub-scale of Symptom Checklist-90 were provided to all patients and healthy controls. All participants were examined by a gastroenterologist and a psychiatrist. RESULTS: Healthy controls were younger than organic dyspepsia group and women/men rate was lower in organic dyspepsia than other two groups. Depression score was higher in functional dyspepsia group than in healthy controls and functional dyspepsia group's attachment syle was more secure than that of the healthy control group. Somatization rate was seen higher in functional dyspepsia group with psychiatric examination. There was no significant difference seen in anxiety, alexithymia and social support between the three groups. DISCUSSION: Anxious-avoidant attachment profile as well as the higher propensity to have depressive and anxiety symptoms might be critical psychiatric and psychosocial factors underlying FD's aetiology. A multidisciplinary approach is needed in the follow up of functional dyspepsia patients. Psychological evaluation and treatment would increase the life quality of dyspepsia patients.

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The role of psychiatric symptoms, alexithymia, and maladaptive defenses in patients with functional dyspepsia

Abstract: Psychiatric symptoms, alexithymia, and maladaptive defense play significant role in the emergence of FD symptoms. This study proposes that FD patients should be evaluated and treated by departments of gastroenterology and psychiatry.

Cited by 7 publications

References 31 publications

Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Role of Alexithymia, Anxiety, and Depression in Predicting Self-Efficacy in Academic Students

Evaluation of depression, anxiety, alexithymia, attachment, social support and somatization in functional dyspepsia

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