Alexithymia in Adolescents with Inflammatory Bowel Disease

Abstract

Adolescents with inflammatory bowel disease exhibit increased psychosocial problems, such as higher rates of depressive symptoms; however, the relationship between psychological factors and health outcomes remains relatively unstudied in this pediatric population. Both depression and stress have been linked to health outcomes in adults with inflammatory bowel disease. Alexithymia, defined as a personality trait and affective deficit disorder, may represent another psychological variable influencing health outcomes in inflammatory bowel disease populations. While no prior studies have investigated alexithymia in adolescents with inflammatory bowel disease, higher rates of alexithymia have been documented and associated with poorer quality of life in adults with inflammatory bowel disease. This study investigated the prevalence of alexithymia in adolescents with inflammatory bowel disease and examined the relationship between alexithymia and other psychological variables (i.e., depressive symptoms and perceived stress). An additional aim was to determine whether these psychological variables predicted adolescent inflammatory bowel disease patients’ health outcomes. An investigation of 63 participants with inflammatory bowel disease between the ages of 13 to 17 years revealed a significant prevalence of alexithymia compared to a previously reported rate in a normal adolescent population. Higher alexithymia scores were associated with greater depressive symptoms, perceived stress of major life events, perceived stress of daily hassles, and perceived recent stress. None of the psychological variables were significantly related to illness course, and only perceived stress of major life events was significantly correlated with disease severity. In contrast, all of the psychological variables showed significant inverse correlations with disease-specific quality of life. Notably, alexithymia emerged as the strongest predictor of disease-specific quality of life and consistently accounted for more unique variance than depressive symptoms and perceived stress. Taken together, the present results implicate alexithymia as a risk factor for poor illness perception and adjustment in adolescents with inflammatory bowel disease. The potential lifelong repercussions of alexithymia make it an important topic for health outcome research, which may guide the development of psychological interventions for this pediatric chronic illness population.