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David Baxter

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Is alexithymia a new type of mood disorder?
Wednesday, 12 September 2007

A group of University of Tilburg, The Netherlands, researchers has suggested that alexithymic depression may be a new type of mood disorder.

Alexithymia is a state of being less able to understand, process or describe emotions. It is defined by:

  • difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal,
  • difficulty describing feelings to other people,
  • constricted imagination with a paucity of fantasies,
  • a stimulus-bound, externally oriented cognitive style.
About 10% of the population has alexithymia to some degree.

Given the observation that alexithymia and depression are correlated, plus evidence that these constructs are distinct, the researchers examined whether alexithymia could define a subgroup of clinical depression.

Clinically oriented research suggests that alexithymic depressed patients constitute a specific group:

  • irrespective of the degree of depression, they have more suicidal ideation,
  • more somatic symptoms of distress and
  • respond significantly less well to the antidepressant medication paroxetine than nonalexithymic depressed patients.
The research involved 30 Belgian mental health care centers. Self-report questionnaires were sent to adult outpatients. In total 404 patients (71.93%) returned the questionnaires, measuring depression (Beck Depression Inventory - BDI) and alexithymia (Toronto Alexithymia Scale -TAS-20).

Significant group differences were observed for 2 biographical variables - in the strongly alexithymic group women are more strongly represented, and fewer of them had children. There was no correlation with age, relational status, educational level or any of the DSM-IV diagnoses on axis I or II. From the self-report questionnaires the researchers noted that the strongly alexithymic group had more somatic-affective depression symptoms and more cold/distant interpersonal functioning.

This study suggests that based on the TAS-20 , 2 distinct subgroups of depressed patients (strong vs. moderate alexithymia) can be seen. The strongly alexithymic group has more somatic-affective depressive symptoms and withdrawn interpersonal functioning. The groups did not differ with respect to other interpersonal problems, cognitive depressive symptoms, the dimensions of dependency and self criticism, or any of the DSM-IV diagnoses.

Source: Vanheule S, Desmet M, Verhaeghe P, Bogaerts S. Alexithymic depression: evidence for a depression subtype? Psychother Psychosom. 2007;76(5):315-6.
 

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