van Kerkhoven Lieke A S, van Rossum Leo G M, van Oijen Martijn G H, Tan Adriaan C I T L, Witteman Ellen M, Laheij Robert J F, Jansen Jan B M J
Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
J Clin Gastroenterol. 2006 Mar;40(3):195-9. doi: 10.1097/00004836-200603000-00005.
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.
To determine whether alexithymia might be a useful factor in predicting GI endoscopy outcomes.
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.
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).
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.
述情障碍是指一个人在区分情绪和身体感觉方面存在困难，被认为是一种性格特质和多种身心障碍的易患因素。因此，在内镜检查前评估有胃肠道（GI）症状患者的述情障碍，可能有助于筛选出更易患功能性胃肠疾病的患者。
确定述情障碍是否可能是预测胃肠内镜检查结果的有用因素。
纳入2002年2月至2004年2月期间接受内镜检查的患者。他们被要求在内镜检查前2周根据多伦多述情障碍量表-20报告述情障碍情况。从医疗档案中获取内镜诊断信息。
共纳入1141名受试者（49%为男性），其中245人（21%）报告有述情障碍。胃肠内镜检查时有内镜器质性异常的患者（51±12）和无异常的患者（50±12），其述情障碍评分的平均值±标准差无差异。根据上消化道或下消化道内镜检查中最突出的发现分为亚组后，与述情障碍无关联。有述情障碍的患者在入组研究前的最后几周报告胃肠道症状感觉更差（症状严重程度评分的平均值±标准差分别为42±34和34±30；P<0.01）。
述情障碍与内镜检查结果无关，因此在预测内镜检查结果方面没有附加价值。有述情障碍的患者更常出现更多、更严重的胃肠道症状。
