Is alexithymia a risk factor for unexplained physical symptoms in general medical outpatients?

Objective: Alexithymia is presumed to play an important predisposing role i n the pathogenosis of medically unexplained physical symptoms. However, no research on alexithymia has been done among general medical outpatients who present with medically unexplained physical symptoms as their main problem and in which anxiety and depression have been considered as possible confo unding factors, This study investigated whether patients with medically une xplained physical symptoms are more alexithymic than those with explained s ymptoms and whether, in patients with unexplained symptoms, alexithymia is associated with subjective health experience and use of medical services. M ethods: We conducted a cross-sectional study among patients attending an in ternal medicine outpatient clinic. All patients were given a standardized i nterview and completed a number of questionnaires. Results: After complete physical examinations, 169 of 321 patients had unexplained physical symptom s according to two independent raters. Patients with medically unexplained symptoms more often had a mental disorder, but overall they were not more a lexithymic. In patients with unexplained physical symptoms, alexithymia was not associated with subjective health experience or use of medical service s. However, patients with both unexplained symptoms and a mental disorder w ho also denied any possible connection between emotional problems and their physical symptoms did have more alexithymic traits. Conclusions: In the ma jority of patients with medically unexplained physical symptoms, alexithymi a does not play a role of clinical significance. Patients with unexplained physical symptoms are heterogeneous with respect to psychiatric syndrome pa thology and probably also with respect to personality pathology.