Somatisation and alexithymia in patients with high use of medical care and medically unexplained symptoms

Background and objective Few reports in the medical literature examine physician agreement on a standard assessment for somatisation in primary care patients. We describe somatising patients who were subjectively identified by family physicians and subsequently classified on the somatisation spectrum by a standard evaluation. We also examine the relation between somatisation and alexithymia.Method Responding to a brief verbal prompt, family physicians referred high-utilising patients 18 years old and older who had 'persistent medically unexplained symptoms for at least 6 months' (n = 72). Patients who agreed to participate in the study (n = 48) were assessed individually using a structured diagnostic interview and two measures of alexithymia.Results All participating patients met inclusion criteria for one of two abridged subtypes on the somatisation spectrum. Somatisation was not related to alexithymia.Conclusions Family physicians subjectively identified patients who had somatisation, with a high level of accuracy and without formal screening or diagnostic tests. Embedded in a disease-management system, especially an electronic version, a brief verbal prompt to physicians to identify patients on the somatisation spectrum could potentially realise considerable savings in physician time and medical system financial expenditures.     

Dreaming correlates of alexithymia among sleep-disordered patients.

Increasing evidence supports the clinical view that alexithymia is associated with disturbed dreaming. However, a consistent, replicable pattern of relationships between alexithymia and different dreaming components has not yet been identified. Groups of sleep-disordered outpatients (N = 580; 46.0 ± 13.2 years) and nonclinical controls (N = 145; 22.9 ± 4.2 years) were administered the Toronto Alexithymia Scale (TAS-20) and a 14-item Dreaming Questionnaire. Sleep diagnoses were assessed from polysomnography and clinical histories following the American Academy of Sleep Medicine classification system. The Dreaming Questionnaire was reduced by principal-components analysis to a 3-factor solution that distinguishes nightmare distress, dream recall, and dream meaning items. Factor coefficients were correlated with TAS total score and TAS subscales while age was controlled as a covariate. TAS total score was found to correlate positively with nightmare distress and negatively with dream recall for both clinical and nonclinical groups and for both men and women considered separately. TAS total score also correlated negatively with dream meaning for nonclinical participants. TAS subscales were differentially correlated with the 3 dream factors: difficulty identifying feelings (DIF) with increased nightmare distress, difficulty describing feelings (DDF) with decreased dream recall and externally oriented thinking (EOT) with decreased dream meaning. With some exceptions, these patterns were obtained independently for clinical and nonclinical groups and for men and women within these groups. Findings suggest a consistent and replicable pattern of relationships between alexithymia and dreaming components that implicates processes regulating emotion during both wakefulness and dreaming, for example, affect distress, expressive anxiety, and openness to experience. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Emotional Eating,Alexithymia, and Binge‐Eating Disorder in Obese Women

Objective: To investigate the relationships between alexithymia and emotional eating in obese women with or without Binge Eating Disorder (BED). Research Methods and Procedures: One hundred sixty‐nine obese women completed self‐report questionnaires, including the Beck Depression Inventory, the State Trait Anxiety Inventory, the Stress Perceived Scale, the Dutch Eating Behaviour Questionnaire, and the Toronto Alexithymia Scale. The presence of BED, screened using the Questionnaire of Eating and Weight Patterns, was confirmed by interview. Results: Forty obese women were identified as having BED. BED subjects and non‐BED subjects were comparable in age, body mass index, educational level, and socioeconomic class. According to the Dutch Eating Behaviour Questionnaire, BED subjects exhibited higher depression, anxiety, perceived stress, alexithymia scores, and emotional and external eating scores than non‐BED subjects. Emotional eating and perceived stress emerged as significant predictors of BED. The relationships between alexithymia and emotional eating in obese subjects differed between the two groups according to the presence of BED. Alexithymia was the predictor of emotional eating in BED subjects, whereas perceived stress and depression were the predictors in non‐BED subjects. Discussion: This study pointed out different relationships among mood, alexithymia, and emotional eating in obese subjects with or without BED. Alexithymia was linked to emotional eating in BED. These data suggest the involvement of alexithymia in eating disorders among obese women.     

Binge-Eating Disorder in Brazilian Women on a Weight-Loss Program

Objective: To examine binge-eating disorder (BED) and its association with obesity, weight patterns, and psychopathology in a Brazilian sample of female participants of a weight-loss program in São Paulo, Brazil. Research Methods and Procedures: Two hundred and seventeen overweight (body mass index ≥ 25 kg/m²) women, ages 15 to 59 years, enrolled in the Weight Watchers Program were recruited for the study at a program branch meeting after completing the Questionnaire on Eating and Weight Patterns–Revised, Beck Depression Inventory, and the Toronto Alexithymia Scale-20. Participants were categorized into four groups: those who met questionnaire criteria for BED, those who met questionnaire criteria for bulimia nervosa (BN), those that reported binge eating but did not meet all the criteria for any eating disorder (BE), and those with no eating disorder symptoms (No ED). Groups were compared on measures of weight, depressive symptoms, and alexithymia. Results: Binge eating was frequently reported by women in this study (BED, 16.1%; BN, 4.6%; BE, 22.6%). BED women had significantly higher body mass index, greater highest weight ever, and more frequent weight cycling than the No ED group. BED women also reported more depressive symptoms than BE and No ED women, and were more alexithymic than the No ED group. BE women presented more frequent weigh cycling and were also more depressed and alexithymic than the No ED group. Discussion: BED is not uncommon in overweight Brazilian women, and similar to North American and European samples, it is associated with overweight and higher levels of psychopathology in this population.