The status of alexithymia as a risk factor in medically unexplained physical symptoms

Kooiman, Cornelis G

doi:10.1016/s0010-440x(98)90075-x

Cited by 56Psychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome ResearchMedicine, History, and Philosophy

The status of alexithymia as a risk factor in medically unexplained physical symptoms

Kooiman, Cornelis G·1998·Comprehensive Psychiatry

DOI 10.1016/s0010-440x(98)90075-x

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Abstract

Some decennia ago, the concept of alexithymia was developed from the clinical experience of psychosomaticians who at the time were largely working within a psychoanalytic frame of reference. Alexithymia can briefly be described as a cognitive-affective disturbance characterized by difficulties in differentiating one's feelings and expressing them in words. Clinicians who treat patients with medically unexplained physical symptoms may often recognize alexithymic features in their patients. It is supposed that alexithymia could be a predisposing factor for the development or persistence of medically unexplained physical symptoms. In this review, the concept of alexithymia as well as paradigmatic shifts in psychoanalysis and psychosomatics are discussed to place the concept of alexithymia in its epistemiological context. Furthermore, the empirical literature on the association between alexithymia and medically unexplained physical symptoms is reviewed. The main conclusions are that alexithymia appears to be a theoretically important and clinically appealing concept, but that so far the empirical evidence that alexithymia predisposes to the development or persistence of medically unexplained physical symptoms is imperfect. This is mainly because of the cross-sectional design of most studies and is due to other methodological shortcomings, such as the lack of allowance for depression and anxiety as possible confounding factors. Suggestions for future research are made.

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Alexithymia is related to impoverished general functioning in somatoform disorders.
“Because alexithymia was found to be related to impoverished general functioning in somatoform disorders (2, 11–21), following the classification of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR (22) and other precursors of SSRD, as described in DSM-5 (23), general functioning also may be a relevant outcome of treatment.”
From Alexithymia has no clinically relevant association with outcome of multimodal treatment tailored to needs of patients suffering from somatic symptom and related disorders. A clinical prospective study (2018) · cites this paper as [15]

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Authors: Kooiman, C. G.
Affiliations: Leiden University Medical Center (NL)
Corresponding author: Kooiman, Cornelis G
ORCID: Kooiman, Cornelis G
Venue: Comprehensive Psychiatry
Publisher: Elsevier BV
Published: 1998-05
Volume: 39
Issue: 3
Pages: 152-159
ISSN: 0010-440X (ISSN-L)
DOI: 10.1016/s0010-440x(98)90075-x
OpenAlex: W2059530065
Cited by: 56
References: 80
Citations by year: 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 4 · 2013: 2 · 2012: 5
FWCI: 1.97
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Comprehensive Psychiatry (publishedVersion)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
Keywords: alexithymia, medically unexplained physical symptoms, somatic symptom disorder, risk factors, psychosomatic medicine, psychoanalysis, emotional awareness
MeSH terms: Affective Symptoms, Humans, Terminology as Topic, Psychoanalysis, Psychosomatic Medicine, Research Design, Risk Factors, Somatoform Disorders

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The status of alexithymia as a risk factor in medically unexplained physical symptoms

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