Objectives ： The purpose o f this study was to evaluate the psychosomatic characteristics, especially focusing on alexithymia, the latest issue in psychosomatic medicine, in patients with duodenal ulcers compared with other control groups. Methods ： The study subjects consisted o f duodenal ulcer group(N = 30 ), schizophrenia group (N=30), neurosis group(N=33) and normal healthy group(N=30). All the subjects completed six psychological tests, including four self-reporting scales(MMPI，SCL-90-R, MMPIA and TAS), one observer-rated questionnaire(BIQ) and one projective test(TAT), as well as psychiatric interview. Results ： All the groups were in the normal range o f the scores o f M M P I and SCL-90-R. And the decreasing orders of severity were shown by neurosis, schizophrenia, duodenal ulcer and normal healthy groups, and all. the groups were clearly distinguished by both inventories. On the MMPI and SCL-90-R scales, the duodenal ulcer group showed significantly higher scores in the hypochondriasis, depression, hysteria, psychasthenia and somatization subscales, compared with the normal control(p〈0.05). On the BIQ, the duodenal ulcer group showed significantly higher mean score, compared with the other control groups(p〈0.05). All the mean scores of the MMPI-A and total TAS were, however, below the alexithymic level and had no significant differences among the four subject groups. The total word count combined from nine TAT cards showed significant differences among the four subject groups(p〈0.0001). The normal control group scored the highest in total word count among all the groups. On the contrary, the duodenal ulcer group showed the lowest score and it was significantly lower than in the normal group(p〈0.05). The neurosis group scored the highest, while the duodenal ulcer group had no significant differences compared with the rest of the groups, in the affective word count combined from nine TAT cards. Conclusion ： First o f all, there are significant tendencies o f hypochondriasis, depression, hysteria, psychasthenia and somatization in duodenal ulcer patients compared with normal healthy people. Secondly, the BIQ and total word count of TAT may be useful in evaluating alexithymic trait in psychosomatic patients compared with normal healthy people and other psychiatric patients. Thirdly, the assumption that alexithymia is the unique personality trait of the classical psychosomatic diseases can t be confirmed because of inconsist results in this study. Fourth, these inconsistent results may be related to a recent opinion that there is considerable variation in the prevalence of the alexithymic trait among different psychiatric diseases as well as psychosomatic diseases, and that alexithymia may coexist with, but may be independent from, neurotic psychopathology. Finally, further studies are required to clarify the impact of alexithymia on various psychosomatic diseases in the context of biopsychosocial approach.
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