This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kooiman, C. G. Articles by Trijsburg, R. W. Search for Related Content PubMed PubMed Citation Articles by Kooiman, C. G. Articles by Trijsburg, R. W. Related Collections Personality Somatoform

Alexithymia Does Not Predict the Persistence of Medically Unexplained Physical Symptoms

From the Department of Psychiatry (C.G.K., H.G.M.R.) and the Department of General Internal Medicine (J.H.B.) of the Leiden University Medical Center, and the Department of Medical Psychology and Psychotherapy, Erasmus University Rotterdam (R.W.T.), Rotterdam, the Netherlands.

Address correspondence and reprint requests to Cornelis G. Kooiman, Department of Psychiatry B1P, Leiden University Medical Center, 2300 RC Leiden, the Netherlands. E-mail: cgkooiman{at}lumc.nl

BACKGROUND: Alexithymia is thought to be associated with the development of medically unexplained physical symptoms (UPS). So far little research has been published on alexithymia as a risk factor for the persistence of UPS.

OBJECTIVE: To determine the clinical outcome in UPS patients and to study the relative importance of alexithymia in predicting that outcome.

METHODS: A follow-up study was conducted among general medical outpatients with UPS. Patients underwent extensive examinations at baseline and were reassessed after a mean 61-week interval. Outcome of the UPS and general health perception at follow-up were used as major outcome variables.

RESULTS: Outcome of the UPS and general health perception at follow-up were not strongly associated with each other. More than half (63%) of the patients reported improvement of their initial symptoms, but only 38% of the patients considered themselves at follow-up to be in good health. UPS outcome was predominantly predicted by the duration of the UPS and the number of additional physical symptoms at baseline. General health perception at follow-up was predominantly predicted by the general health perception at baseline and the number of additional physical symptoms and pain experience at baseline. The explained variance of the general health perception was three times as high as the explained variance for the UPS outcome. Alexithymia was not associated with any of the two outcome variables.

CONCLUSIONS: Outcome of the UPS and general health perception at follow-up are not strongly associated and are predicted by different variables. Alexithymia, however, is not an important predictor for the outcome in the majority of UPS patients.

Key Words: alexithymia, • somatization, • unexplained physical symptoms, • prognosis, • follow-up study,

Abbreviations: DES = Dissociative Experience Scale;; EPS = explained physical symptoms;; ESR = erythrocyte sedimentation rate;; HADS = Hospital Anxiety and Depression Scale;; HADSa = HADS Anxiety scale;; HADSd = HADS Depression scale;; PSQ = Physical Symptoms Questionnaire;; RCI = Reliable Change Index;; TAS-20 = Toronto Alexithymia Scale-20;; UPS = unexplained physical symptoms;; WI = Whiteley Index.

This article has been cited by other articles:

				A. K. Mattila, E. Kronholm, A. Jula, J. K. Salminen, A.-M. Koivisto, R.-L. Mielonen, and M. Joukamaa Alexithymia and Somatization in General Population Psychosom Med, July 1, 2008; 70(6): 716 - 722. [Abstract] [Full Text] [PDF]

				F. Friedberg and J. Quick Alexithymia in Chronic Fatigue Syndrome: Associations With Momentary, Recall, and Retrospective Measures of Somatic Complaints and Emotions Psychosom Med, January 1, 2007; 69(1): 54 - 60. [Abstract] [Full Text] [PDF]