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Alexithymia is Associated With Gastrointestinal Symptoms, but Does Not Predict Endoscopy Outcome in Patients With Gastrointestinal Symptoms

van Kerkhoven, Lieke A. S. MSc; van Rossum, Leo G. M. MSc; van Oijen, Martijn G. H. MSc; Tan, Adriaan C. I. T. L. MD, PhD; Witteman, Ellen M. MD, PhD; Laheij, Robert J. F. PhD; Jansen, Jan B. M. J. Prof MD, PhD

Journal of Clinical Gastroenterology: March 2006 - Volume 40 - Issue 3 - p 195-199
Alimentary Tract: Clinical Research

Background Alexithymia, where a person has difficulty in distinguishing between emotions and bodily sensations, is considered to be a character trait and a vulnerability factor for various psychosomatic disorders. Assessing alexithymia in patients with gastrointestinal (GI) symptoms before endoscopy might therefore be useful in selecting patients who are more prone to functional GI disorders.

Goal To determine whether alexithymia might be a useful factor in predicting GI endoscopy outcomes.

Study Patients referred for endoscopy between February 2002 and February 2004 were enrolled. They were asked to report alexithymia on the Toronto Alexithymia Scale-20 2 weeks before endoscopy. Information about endoscopic diagnoses was obtained from medical files.

Results A total of 1141 subjects was included (49% male), of whom 245 (21%) reported alexithymia. There was no difference in mean±SD alexithymia scores between patients with (51±12) and without (50±12) an endoscopic organic abnormality at GI endoscopy. When divided into subgroups, according to the most prominent finding at either upper or lower GI endoscopy, there was no association with alexithymia. Patients with alexithymia reported a worse sensation of GI symptoms during the last weeks before enrollment in the study (mean±SD symptom severity score: 42±34 vs. 34±30, respectively; P<0.01).

Conclusions Alexithymia is not associated with endoscopic findings, and has therefore no additive value in predicting endoscopy outcomes. Patients with alexithymia more often present with a higher number and more severe GI symptoms.

*Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center

Department of Internal Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands

Supported by SWOIG, Foundation for Scientific Research Internal Medicine Canisius Wilhelmina Hospital, Nijmegen.

Reprints: Lieke A. S. van Kerkhoven, M.Sc, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands (e-mail:

Received for publication June 7, 2005; accepted September 1, 2005

Copyright © 2006 Wolters Kluwer Health, Inc. All rights reserved.