Abstract

Abstract Background Alexithymic traits are quite prevalent in patients with inflammatory bowel diseases (IBD) and have been linked with a heightened psychological burden including anxiety, depression, somatization and obsessive-compulsive symptoms. However, there are limited data regarding the association of alexithymia with gastrointestinal symptom severity and disease activity. Methods The current study was conducted at the Division of Gastroenterology of the University Hospital of Patras, in Greece with the collaboration of the Department of Psychiatry. Adult IBD outpatients and healthy controls were enrolled to the study. Alexithymic traits were assessed with the Toronto Alexithymia Scale (TAS-20). Disease activity was assessed with the calculation of the Truelove-Witts Index for ulcerative colitis (UC) patients and the Harvey-Bradsaw Index for Crohn’s disease (CD) patients. Results 57 IBD patients and 50 healthy controls entered the study. 26 (45.6%) IBD patients reported clinically significant alexithymia traits. In addition, IBD patients faced increased difficulties in emotional expression (p=0.024) and reported increased overall alexithymic traits (p=0.033) compared to healthy controls. Moreover, we detected a borderline tendency of IBD patients to exhibit more disturbances in emotional recognition (p=0.067) compared to the control group. Difficulties in emotional recognition were significantly correlated with the presence of nausea (p=0.031), belly pain (p=0.015) and bloating (p=0.018), while overall alexithymic traits were strongly associated with the presence of nausea (p=0.008). Finally, increased disease activity was significantly associated with a higher total alexithymia score in Crohn’s disease (p=0.037) and ulcerative colitis (p=0.047) patients. Conclusion IBD patients report increased alexithymic traits which are associated with more severe gastrointestinal symptomatology and increased disease activity.

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