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

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.