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Background: The Diagnostic Criteria for Psychosomatic Research (DCPR) have been demonstrated to be useful in identifying specific psychological conditions of medical patients. The aim of this study was to evaluate the clinical utility of the DCPR in predicting the treatment outcome of patients with functional gastrointestinal disorders (FGID). Methods: FGID outpatients were allocated to improved (n = 65) and unimproved (n = 40) groups on the basis of preestablished criteria following 6 months of treatment. Patients were administered the structured interview for DCPR at baseline and the Gastrointestinal Symptom Rating Scale both at baseline and follow-up. Results: In the unimproved patients, the prevalence of the DCPR categories of alexithymia (82.2%) and persistent somatization (72.5%) was significantly higher while health anxiety was more prevalent in improved patients (21.5%). No unimproved patient lacked a DCPR diagnosis while multiple DCPR diagnoses were significantly higher in the unimproved group (90%). In the regression analysis, alexithymia, persistent somatization, a higher number of DCPR diagnoses for each patient and, to a lesser extent, greater symptom severity at baseline were significant predictors of unimprovement. Health anxiety, even after controlling for gastrointestinal symptoms, was a significant predictor of improvement. Conclusion: The ability to predict treatment outcome indicates the clinical utility of the DCPR. Clinicians may improve treatment outcome for FGID patients by identifying particular psychosomatic syndromes (alexithymia, persistent somatization, and health anxiety) and patients with multiple DCPR clusters, and attempting to address specific therapeutic interventions.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Alexithymia and psychopathology may influence the way individuals experience psychological distress and somatic symptoms. This study evaluated patients referred to psychiatric and gastroenterologic outpatient settings in order to investigate the levels of alexithymia and psychopathology, and the possible role of alexithymia in symptom perception and health care utilization. The association between psychiatric disorders and functional gastrointestinal disorders (FGIDs) was also assessed. Methods: Psychopathology (by the Revised 90-item Symptom Checklist), alexithymia (by the 20-item Toronto Alexithymia Scale), and gastrointestinal symptoms (by the Gastrointestinal Symptom Rating Scale) were evaluated in 52 psychiatric outpatients and 58 medical outpatients with FGIDs. Two comorbid subgroups of 25 psychiatric patients with FGIDs and 38 FGID patients with psychiatric disorders were formed and compared. Results: Forty-eight percent of the psychiatric patients had associated FGIDs, and 65.5% of the FGID patients had associated psychiatric disorders. The FGID patients had significantly less psychopathology, but significantly higher alexithymia and more severe gastrointestinal symptoms, than the psychiatric patients. In the comparison of the two subgroups with comorbidity, FGID patients with psychiatric disorders were still more alexithymic and had less psychopathology than psychiatric patients with FGIDs, but gastrointestinal symptoms were not significantly different. Conclusion: Patients with ‘functional’ gastrointestinal symptoms attending a medical care service are likely to be highly alexithymic, whereas those attending a psychiatric care service are likely to show severe psychopathology. Alexithymia seems to influence the presentation of ‘functional’ somatic symptoms and the type of health care utilization.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]