Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt

Ahmed Rady1, *, Roa Gamal Alamrawy2, Ismail Ramadan3, Mervat Abd El Raouf 3
1 Department of Psychiatry, Alexandria University, School of Medicine, Alexandria, Egypt
2 Mamoura Psychiatric Hospital, Secretariat of Mental Health and Addiction Treatment, Alexandria, Egypt
3 Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 1153
Abstract HTML Views: 443
PDF Downloads: 462
Total Views/Downloads: 2058
Unique Statistics:

Full-Text HTML Views: 639
Abstract HTML Views: 227
PDF Downloads: 261
Total Views/Downloads: 1127

Creative Commons License
© 2021 Rady et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Psychiatry, Alexandria University School of Medicine, Egypt, 29, Nabi Daniel St., Alexandria 21131, Egypt; Tel: +2 01282441053; E-mail:;



There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds.


This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data.


In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale.


General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the ‘difficulty identifying feelings’ dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05).


Alexithymia is associated with the development of MUPS.

Keywords: Medically unexplained physical symptoms, Alexithymia, Somatic symptoms, Toronto alexithymia scale (TAS-20), Patient health questionnaire (PHQ-15), Dyspepsia.