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* = Presenting author

P669 The prevalence of alexithymia in inflammatory bowel disease: a systematic review and meta-analysis

C. Hopkins*1, C. Moulton2

1Berkshire Healthcare NHS Foundation Trust, Prospect Park Hospital, Reading, United Kingdom, 2Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom

Background

Alexithymia is a dimensional personality trait, characterised by deficits in the cognitive processing and identification of emotions. An alexithymia prevalence rate of 9% has been reported in the general population, although higher rates have been identified in multiple chronic diseases, with detrimental moderating effects upon symptom experience, health-related quality of life, and coping observed. Given the potential implications of alexithymia upon prognosis in inflammatory bowel disease (IBD), this study sought to systematically examine whether there is an increased prevalence and risk of alexithymia in IBD patients.

Methods

The study protocol was prospectively registered with PROSPERO (CRD42015027402). EMBASE, Medline, PsycINFO, and Web of Science were systematically searched for cross-sectional, case-control, and cohort studies using the validated Toronto Alexithymia Scale (TAS; including both the 20- and 26-item tools) to report a prevalence or severity (mean score) of alexithymia in IBD patients. Using the derSimonian–Laird random effects model, OpenMeta, was used to calculate a pooled prevalence estimate for alexithymia in IBD patients. Using eligible case-control studies, OpenMeta random effects models were again used to calculate an odds ratio for alexithymia in IBD patients compared with healthy controls. Univariate meta-regression and sub-group meta-analysis were also performed to examine the interaction between possible confounders (TAS tool and diagnostic threshold used, IBD disease type, age, sex, disease duration, presence of active disease, and prevalence of anxiety and depression) and alexithymia prevalence.

Results

The systematic search yielded 343 unique texts and, of these, 12 and 10 studies satisfied criteria for inclusion in qualitative and quantitative analyses, respectively. In total, 1 605 participants (52.0% male; mean age: 42.4 years) were included in the quantitative analysis. A pooled prevalence estimate for alexithymia in IBD patients of 34.1% (95% CI 21.0–47.1%) was calculated. Alexithymia occurred significantly more frequently in patients with IBD versus healthy controls, with an odds ratio of 7.6 (95% CI 4.4–13.3; p < 0.001). Univariate meta-regression and sub-group meta-analysis identified no significant interaction between alexithymia prevalence and relevant variables.

Conclusion

This analysis demonstrates that there is a significant increase in the prevalence and risk of alexithymia in IBD patients compared with the general population. Given the potential modifying effects that alexithymia may have upon symptom perception, health-related quality of life, and other outcomes in IBD, further prospective studies examining alexithymia and its interaction with IBD are warranted.