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Key Words
Affective symptoms * Alexithymia * Depression * Follow-up * Therapeutics
Abstract
Background: A six-month follow-up study was conducted to determine whether alexithymia is a permanent feature in 169 depressed outpatients. Methods: Diagnosis of depression was confirmed by means of the Structured Clinical Interview for DSM-111-R (SCID-I). Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale (TAS-20) and severity of depression was assessed using the 21-item Beck Depression Inventory (BDI). Results: Almost 40% of the patients were considered alexithymic at baseline, but only 23% at follow-up. Alexithymic patients were more often moderately or severely depressed than other patients in both study phases. The BDI scores explained 23% (at baseline) and 42% (at follow-up) of the variation in TAS-20 scores. The decrease in the TAS-20 scores was associated with a concurrent decrease in BDI scores. Conclusions: Alexithymic patients with depressive disorders do not appear to form a stable group. On the contrary, alexithymia seems to change as a function of depression. In
the light of these results, alexithymia appears not to be a stable personality trait among depressed patients, and furthermore, it seems possible that alexithymic features respond to psychiatric treatment.
Introduction
The original definition given to alexithymia was the inability to identify and use language to describe feelings [1, 21. A poverty of imagination or of a fantasy world [3, 4], as well as a lack of positive emotions and a high prevalence of negative emotions have also been considered to be characteristic of alexithymia [5].
A relationship between depressive mood and alexithymia has been found in several studies [6-12]. However, contradictory views prevail concerning the exact nature of this connection. Some studies support the independence of alexithymia and depression [ 13, 14]. Conversely, results from two earlier studies [6, 10] support an overlapping association between depression and alexithymia. Alexithymia, as a clinical state, has also been interpreted to be secondary [ 15, 16], mainly a coping or a primitive defence mechanism [ 17, 18] for life-threatening situations [10]. Nevertheless, the design of those earlier studies has usually been cross-sectional, and thus, no causal relationship could be made.
Although a number of follow-up studies have examined the stability of alexithymia [6, 11, 19-22], none of these...