Psychosomatic syndromes and anorexia nervosa

Giovanni Abbate-Daga,Cristina Giovannone,Nadia Delsedime,Federico Amianto,Barbara Nicotra,Enrica Marzola,Secondo Fassino

doi:10.1186/1471-244x-13-14

Giovanni Abbate-Daga, Cristina Giovannone + Show 5 more

Open Access

https://doi.org/10.1186/1471-244x-13-14

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Journal: BMC Psychiatry	Publication Date: Jan 9, 2013
Citations: 91	License type: cc-by

Affiliation: University of Turin

Abstract

BackgroundIn spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR) to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients.Methods108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP) were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory–2, and Temperament and Character Inventory. Data were submitted to cluster analysis.ResultsIllness denial (63%) and alexithymia (54.6%) resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%), somatization group (26%), and severe psychosomatic group (25%). The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome.ConclusionsThese results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments.

Highlights

In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN
To the best of our knowledge, in literature there is only one study, conducted by our group, that applied the four syndromes of the area “Psychological factors influencing vulnerability to illness” of DPCR to 101 Eating Disorder (ED) outpatients [13]. Since it was a preliminary study we considered only the four syndromes providing a better specification of the Diagnostic and Statistical Manual-IV (DSM-IV) rubric of psychological factors affecting medical condition, excluding the eight factors related to somatisation
AN-BP individuals were characterized by older age and longer duration of illness

Summary

Introduction

In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN), few studies have investigated the prevalence of psychosomatic syndromes in AN. Some authors have recently highlighted the role of several factors like alexithymia [4], emotion and anger dyscontrol [5], and somatization [6] in both development and maintenance of the disorder. It has been described a psychosomatic and somatopsychic vicious circle as underpinning AN symptomatology [7,8,9]. DCPR variables may occur in conjunction with any psychiatric disorder listed in the DSM–IV or with any medical disorder [18]

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