S-42-01

Alexithymia across the life span

M. Joukamaa. Tampere School of Public Healt, Tampere, Finland

Objective: Several population studies on alexithymia with representative samples have been published in recent years. We studied the association of alexithymia and socio demographic factors by reviewing these studies.

Methods: A review of five published articles (three of them with working age people and two with elderly people) and of two unpublished manuscripts (one with a large age scale 30-90 years old people, one with 15-16 years aged young people).

Results: About one tenth of working age people is alexithymic, men more commonly than women. This holds also on teen age people. Alexithymia is associated with living alone, low education and unemployment. Among elderly people the prevalence of alexithymia is almost three times as high and there do not exist any gender difference. Among elderly also the association with other socio demographic factors seems to be weaker.

Conclusion: Alexithymia is associated with many socio demographic factors. This should be kept in mind when assessing the associations of different somatic diseases and mental disorders with alexithymia.

S-42-02

The role of alexithymia in the natural history of the functional gastrointestinal disorders

P. Porcelli. IRCCS De Beilis Hospital Psychosomatic Unit, Castellana Grotte, Italy

Objective: To investigate the role of alexithymia in the natural history of Functional Gastrointestinal Disorders (FGID).

Methods: Systematic review of literature.

Results: Pre-clinical stage of symptom perception: alexithymia was higher in FGID patients than patients with organic GI disease (IBD) and healthy subjects, even after controlling for moderator variables. Diagnostic stage of health care referral: alexithymia was higher in FGID patients with psychopathology referred to a GI setting than psychiatric outpatients with GI syndromes referred to a mental health care setting, even after controlling for psychiatric-GI comorbidity. Clinical stage of treatment response: alexithymia was a significant predictor of non-response to treatment in FGID patients, over and above high psychological symptoms of anxiety and depression. Outcome stage of symptom maintenance: alexithymia was a significant predictor of persistence of functional GI symptoms in cholecystectomized patients with gallstone disease one year after surgery, over and above psychological distress.

Conclusion: Speculative hypotheses of explanation on the role of alexithymia across the different stages of the natural history of FGID may concern the cognitive deficit in emotional processing and the neurobiological correlates of both FGID and alexithymia related to the dysregulation of the prefrontal and anterior regions of the brain.

S-42-03

Alexithymia in obsessive compulsive disorder - Results from a family study

G. J. Grabe, S. Ettelt, S. Ruhrmann, M. Wagner. University of Greifswald Psychiatry, Stralsund, Germany

Objective: Previous studies have suggested an association between alexithymia and obsessive-compulsive disorder (OCD). However, it is unclear to which extent alexithymic traits in OCD patients reflect familial deficits in cognitively processing and communicating feelings that are also present in their first degree relatives. This paper investigates the hypotheses of an elevated level of alexithymia in subjects with OCD and their first degree relatives compared to controls and their first degree relatives.

Methods: 82 cases with OCD and 169 first degree relatives were compared to 76 controls and 144 first degree relatives from a German family study on OCD (GENOS) completed the Toronto- Alexithymia-Scale 20 (TAS-20). Direct interviews or family informant information were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia - Lifetime version for anxiety disorders (DSM-IV).

Results: OCD was associated with significantly higher scores of alexithymia. However, first degree relatives of OCD cases and of controls had comparable TAS-20 scores. In linear regression analyses, the TAS-20 total score showed significant intrafamilial associations within the families of control subjects but not within families of OCD cases.

Conclusion: OCD is a severe mental disorder that is associated independently from other current comorbid axis-I disorders with deficits in identifying and expressing feelings. These deficits seem to be restricted to the affected subjects and are not present in their first degree relatives. However, in general, alexithymia represents a familial trait.

S-42-04

J. Salminen, S. Saarijarvi, T. Toikka, J. Kauhanen. National Public Health Instit. Dept, of Health/Functional C., Turku, Finland

Objective: To test the temporal stability of alexithymia in the general population when psychological distress was controlled for.

Methods: Methods: The 20-item Toronto Alexithymia Scale (TAS-20) and the 12-item version of the General Health Questionnaire (GHQ-12) was mailed to 1285 subjects representing the general population and who had responded to our similar query five years earlier (1996).

Results: A total of 901 subjects (M=387; F=514) responded (70%). The baseline mean score of the TAS-20 was 48.4 for men and 44.0 for women, and at the follow-up 47.5 and 42.9, respectively (i—0.69 for men, and 0.66 for women). The mean score for the GHQ-12 at the baseline was 1.9 for men and 2.1 for women, and 2.0 and 2.2 at the follow-up, respectively (r=0.36 for men, and 0.32 for women). The 5-year correlation between the change of the TAS-scores and the change of the GHQ-scores was 0.24.

Conclusion: There is a modest correlation between change in alexithymia and psychological distress in the general population. However, the correlation of alexithymia scores over five years is much stronger than the correlation of psychological distress scores. This supports idea that alexithymia is a relatively stable personality construct rather than a state dependent phenomenon.