Background: Given the role of alexithymia—as the inability to identify, differentiate, and express emotions—in chronic and immune-mediated illness, this systematic review analyzed the prevalence of alexithymia in patients with inflammatory bowel diseases (IBDs), mainly represented by Crohn's disease (CD) and ulcerative colitis (UC). Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed throughout this systematic review of the literature published between 2015 and 2020 in indexed sources from PubMed, PsycINFO, Scopus, and Web of Science databases. Search terms for eligible studies were: “Inflammatory bowel disease” AND “Alexithymia” [Titles, Abstract, Keywords]. Inclusion criteria were: articles written and published in English from 2015 and up to April 2020, reporting relevant and empirical data on alexithymia and IBD. Results: The initial search identified 34 indexed scientific publications. After screening, we found that five publications met the established scientific inclusion criteria. Overall, the mean value of alexithymia ranged from 39 to 53.2 [Toronto Alexithymia Scale (TAS-20) score], thus mostly falling in non-clinical range for alexithymia (≤51). Comparisons of alexithymia between patients with UC and CD highlighted that patients with CD showed externally oriented thinking and difficulties identifying feelings to a greater extent. Regarding comparisons with other samples or pathologies, patients with IBD were more alexithymic than healthy controls and less alexithymic than patients with major depressive disorder, but no difference was found when compared with patients with irritable bowel syndrome (IBS). Then, regarding correlations with other variables, alexithymia was positively associated with anxiety and depression, as well as with psychopathological symptoms and somatic complaints. Conclusion: This systematic review suggests that patients with IBD cannot be generally considered alexithymic at a clinically relevant extent. However, their greater alexithymic levels and its associations with psychological variables and somatic distress may suggest a reactivity hypothesis, in which living with IBD may progressively lead to impaired emotion recognition over time. Specifically, the relationship between IBD and IBS should be further explored, paying deeper attention to the clinical psychological functioning of CD, as IBD requires more emotional challenges to patients.

Background: Psychological functioning plays an important role in medical conditions and impacts patients' quality of life. Previously, many studies have highlighted the association of metacognition to both the development and maintenance of emotional disorders. Recently, several researchers pointed out the relevant role of dysfunctional metacognitive beliefs in the context of chronic diseases. Hence, dysfunctional metacognitive beliefs could be directly related to anxiety and depression, regardless of the medical condition's expression. The aim of this systematic review was to summarize the available evidence regarding the association of metacognition with anxiety, depression, and perceived quality of life, in the context of medical conditions, according to Wells' theory. Methods: A systematic review based on electronic bibliographic databases (PsycINFO, PubMed, Scopus, Web of Science, and Web of Knowledge) of scientific literature was carried out. Studies involving patients evaluated in clinical settings were included in the analysis. Results: Our findings indicated that metacognition appears to be related to anxiety, depression, and quality of life in patients with medical chronic conditions. Therefore, dysfunctional metacognitive beliefs might be a relevant factor associated with the process of adapting to illness. Conclusions: The additional evaluation of metacognitive factors in the context of several medical chronic conditions appears valuable. Due to the rising interest in the study of metacognition, suggestions for future research have also been provided.

Introduction: Age-related medical conditions are increasing worldwide. Type 2 Diabetes mellitus (T2DM) represents a chronic disease, which affects a large amount of general population, accounting for over 90% of diabetes mellitus (DM) cases. Purpose: As psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL). Methods: Forty five patients with T2DM were consecutively recruited and assessed with a psychodiagnostic battery: Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory II edition (BDI-II) and the 36-Item Short Form Health Survey (SF-36), including indexes Physical and Mental Component Summary (PCS, MCS). Moreover, time since DM diagnosis and glycated hemoglobin (HbA1c) values were detected. Results: Participants (mean age 65.3 ± 5.9 years) had a mean time since diagnosis of 11.6 ± 6.7 years, and showed a good metabolic control as highlighted by mean HbA1c values 7.1 ± 0.9%. Median HAM-A score [25(20.7–30.6)], represented high prevalence of anxious symptoms. A moderate expression of depressive symptoms was observed [BDI-II score: 13(8.3–21.4)]. A multiple regression analysis, after correcting for age, BMI, HbA1c value and BDI-II score, showed the perceived quality of life relative to PCS was significantly related to both disease duration (β = −0.55, p = 0.03, SE = 0.25) and HAM-A scores (β = −0.52, p = 0.04, SE = 0.24). Moreover, both HAM-A (β = −0.67, p = 0.01, SE = 0.26) and BDI-II (β = −0.48, p = 0.02, SE = 0.20) scores were independently predictive of MCS. Metabolic control, instead, was not a significant predictor. Conclusion: Our study suggests a predictive role of both anxiety levels and time since diagnosis in perceived HRQoL in T2DM patients. PCS was associated with anxiety and time since diagnosis and MCS was associated with anxiety and depressive symptoms but not with diabetes duration or metabolic control. These data could be useful to plan T2DM training programs focused on psychological health concerns, possibly leading to a healthy self-management and a better perceived HRQoL, even assisting patients in reducing the negative effect due to the chronicization of T2DM.

Background: This systematic review analyzed the relationship between alexithymia, considered as the inability to recognize and express thoughts and emotions, and type 2 diabetes mellitus (T2DM), one of the most common chronic illness, characterized by a metabolic disorder burdened by high morbidity and mortality worldwide due to its outcomes. Methods: PRISMA guidelines were followed throughout this systematic review of the recent literature indexed in the databases PubMed, PsycInfo, Scopus, and Web of Science. Search terms for eligible studies were: “Type 2 diabetes” OR “T2DM” AND “Toronto Alexithymia Scale” OR “TAS-20”[All Fields]. Results: The initial search identified 61 indexed scientific publications. After screening we found that seven publications met the established scientific inclusion and exclusion criteria. It emerged that alexithymic patients ranged from 25 to 50% across the examined publications and it appeared that patients with T2DM generally reflected greater values of alexithymia, revealing particular differences among TAS domains. Moreover, emlpoyed participants were alexithymic to a greater extent compared to non-working participants (77.8 vs. 35.4%) and alexithymia was 2.63 times more severe among working participants when examining predictors of alexithymia. When evaluating the correlations between alexithymia and HbA1c or fasting blood glucose levels we found strong associations equal to 0.75 and 0.77 for TAS-20 total scores, respectively. While alexithymic participants showed significantly higher levels of HbA1c and blood glucose when compared to the non-alexithymic participants. Conclusions: The results of this systematic review of the current literature highlight the need of alexithymia evaluation in patients with T2DM. The high prevalence in T2DM and strong associations with poorly regulated diabetes and psychological distress, indicate a significant relationship between poor glycemic control and psychological distress, such as anxiety and depression, and quality of life. Further studies are needed focusing on age and gender differences in order to be able to improve clinical psychological care and prevention.