Influence of alexithymia on health-related quality of life in inflammatory bowel disease: Are there any related factors?

Abstract

Objective. Alexithymia is a personality trait characterized by difficulty to perceive and express emotions. Previous studies have indicated a high prevalence of alexithymia in patients with inflammatory bowel disease (IBD) but results have been inconsistent. The aim of the present study was to investigate the prevalence of alexithymia in a large IBD cohort and to establish the impact of alexithymia on health-related quality of life (HRQOL) in these patients. Material and methods. A cross-sectional prospective study was undertaken including 534 consecutive IBD patients. Independent variables were measured using one socio-demographic and clinical questionnaire, the hospital anxiety and depression scale (HADS) and the Toronto alexithymia scale (TAS-26). Dependent variables were measured using the short form 36 health survey (SF-36) and the inflammatory bowel disease questionnaire (IBDQ-36). Multiple linear regression and logistic regression were performed to identify factors associated with HRQOL. Results. Participation rate was 91.3%. The overall prevalence of alexithymia was 30.2% (95% CI: 26.0–35.0), with no difference between Crohn's disease and ulcerative colitis. The most affected scales in quality of life were general health (mean = 48.35, 95% CI: 46.43–50.27), vitality (mean = 55.81, 95% CI: 53.59–58.04) and systemic symptoms (mean = 5.19, 95% CI: 5.08–5.29). Alexithymia was significantly associated with an impaired quality of life (OR = 3.34, 95% CI: 1.98–5.65). “Difficulty identifying feelings” and “externally oriented thinking” were the alexithymia factors related to the impaired HRQOL. Conclusions. Alexithymia is highly prevalent in IBD and represents a significant determinant of HRQOL. Alexithymia and its components need to be taken into consideration in the management of IBD patients.

Key Words::

• alexithymia
• Crohn's disease
• health-related quality of life
• inflammatory bowel disease
• personality
• ulcerative colitis

Acknowledgments

We highly appreciate the contribution of Dr. Bjorn Lindkvist, who supported with language and Miss Laura Nieto, who supported with the questionnaires.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.