Porcelli Piero, Affatati Valeria, Bellomo Antonello, De Carne Massimo, Todarello Orlando, Taylor Graeme J
Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Italy.
Psychother Psychosom. 2004 Mar-Apr;73(2):84-91. doi: 10.1159/000075539.
Alexithymia and psychopathology may influence the way individuals experience psychological distress and somatic symptoms. This study evaluated patients referred to psychiatric and gastroenterologic outpatient settings in order to investigate the levels of alexithymia and psychopathology, and the possible role of alexithymia in symptom perception and health care utilization. The association between psychiatric disorders and functional gastrointestinal disorders (FGIDs) was also assessed.
Psychopathology (by the Revised 90-item Symptom Checklist), alexithymia (by the 20-item Toronto Alexithymia Scale), and gastrointestinal symptoms (by the Gastrointestinal Symptom Rating Scale) were evaluated in 52 psychiatric outpatients and 58 medical outpatients with FGIDs. Two comorbid subgroups of 25 psychiatric patients with FGIDs and 38 FGID patients with psychiatric disorders were formed and compared.
Forty-eight percent of the psychiatric patients had associated FGIDs, and 65.5% of the FGID patients had associated psychiatric disorders. The FGID patients had significantly less psychopathology, but significantly higher alexithymia and more severe gastrointestinal symptoms, than the psychiatric patients. In the comparison of the two subgroups with comorbidity, FGID patients with psychiatric disorders were still more alexithymic and had less psychopathology than psychiatric patients with FGIDs, but gastrointestinal symptoms were not significantly different.
Patients with 'functional' gastrointestinal symptoms attending a medical care service are likely to be highly alexithymic, whereas those attending a psychiatric care service are likely to show severe psychopathology. Alexithymia seems to influence the presentation of 'functional' somatic symptoms and the type of health care utilization.
述情障碍和精神病理学可能会影响个体体验心理困扰和躯体症状的方式。本研究对转介至精神科和胃肠科门诊的患者进行评估，以调查述情障碍和精神病理学的水平，以及述情障碍在症状感知和医疗保健利用中的可能作用。还评估了精神障碍与功能性胃肠疾病（FGIDs）之间的关联。
采用90项症状自评量表修订版评估精神病理学，采用20项多伦多述情障碍量表评估述情障碍，采用胃肠道症状评定量表评估胃肠道症状，对52名精神科门诊患者和58名患有FGIDs的内科门诊患者进行评估。形成并比较了两个共病亚组，即25名患有FGIDs的精神科患者和38名患有精神障碍的FGID患者。
48%的精神科患者伴有FGIDs，65.5%的FGID患者伴有精神障碍。与精神科患者相比，FGID患者的精神病理学显著较少，但述情障碍显著较高，胃肠道症状也更严重。在对两个共病亚组的比较中，患有精神障碍的FGID患者仍然比患有FGIDs的精神科患者更具述情障碍，精神病理学更少，但胃肠道症状没有显著差异。
接受医疗服务的有“功能性”胃肠道症状的患者可能高度述情障碍，而接受精神科护理服务的患者可能表现出严重的精神病理学。述情障碍似乎会影响“功能性”躯体症状的表现和医疗保健利用的类型。
