Background: It is often suggested in the literature that alexithymic patients are less responsive to psychotherapy than nonalexithymic patients. However, few empirical studies have examined this issue. Furthermore, it is unclear whether or not alexithymia itself may improve during psychotherapy. Methods: Fifty-five consecutive outpatients with panic disorder received short-term cognitive-behavioral group therapy (CBGT) and were followed up 6 months later. Nineteen patients (35%) were on concomitant antidepressant medication. Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20). Both completers and intention-to-treat analyses were calculated, taking into consideration the potentially confounding effect of comorbid conditions. Results: Baseline alexithymia did not predict outcome of CBGT, neither at posttreatment nor at follow-up. The presence of comorbid axis I disorders predicted nonresponse at posttreatment but not at follow-up. TAS-20 total scores decreased over time, with the TAS-20 factors 1 (difficulty identifying feelings) and 2 (difficulty describing feelings) decreasing significantly, while factor 3 (externally oriented thinking) remained largely stable. Conclusions: These findings are encouraging for cognitive-behavioral therapists working with patients with alexithymia who suffer from panic disorder: CBGT outcome does not appear to be negatively affected by alexithymia, and some alexithymic characteristics may even be reduced following CBGT. Assessing alexithymia at treatment onset may be useful for individually tailoring therapeutic interventions.

BackgroundData about quality of life (QoL) are important to estimate the impact of diseases on functioning and well-being. The present study was designed to assess the association of different aspects of panic disorder (PD) with QoL and to examine the relationship between QoL and symptomatic outcome following brief cognitive-behavioral group therapy (CBGT).MethodsThe sample consisted of 55 consecutively recruited outpatients suffering from PD who underwent CBGT. QoL was assessed by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) at baseline, post-treatment and six months follow-up. SF-36 baseline scores were compared with normative data obtained from a large German population sample.ResultsAgoraphobia, disability, and worries about health were significantly associated with decreased QoL, whereas frequency, severity and duration of panic attacks were not. Treatment responders showed significantly better QoL than non-responders. PD symptom reduction following CBGT was associated with considerable improvement in emotional and physical aspects of QoL. However, the vitality subscale of the SF-36 remained largely unchanged over time.ConclusionsOur results are encouraging for cognitive-behavior therapists who treat patients suffering from PD in groups, since decrease of PD symptoms appears to be associated with considerable improvements in QoL. Nevertheless, additional interventions designed to target specific aspects of QoL, in particular vitality, may be useful to enhance patients’ well-being.

Background and Aims:Some studies have shown that alexithymic patients respond poorly to pharmacotherapy and that alexithymia may have a negative impact on the naturalistic course of psychiatric illnesses. The view that alexithymic patients are also less responsive to psychotherapy is often described in the literature, but few empirical studies have examined this issue, with inconsistent results.Methods:We conducted two prospective studies (pre/post/follow-up) with patients with panic disorder and obsessive-compulsive disorder, to evaluate alexithymia as a potential predictor of the outcome of cognitive-behavioral therapy (CBT) including exposure response management. A further aim was to examine the absolute and relative stability of alexithymia.Results:Regression analyses revealed that alexithymia, as measured with the 20-item Toronto Alexithymia Scale, was related neither to the post-treatment nor to the follow-up outcome. The repeated measures ANOVA showed a significant decrease of alexithymia over time, even after controlling for depression. The high test-retest correlations of alexithymia total and factor scores indicated relative stability of this construct, suggesting that it is a stable personality trait rather than a state-dependent phenomenon in these patients.Conclusions:The results are encouraging for cognitive-behavior therapists working with alexithymic patients with panic disorder and obsessive-compulsive disorder, since the CBT outcome of these patients does not appear to be negatively affected by alexithymia. Furthermore, some alexithymic characteristics may decrease during CBT, even when the therapy program is not specifically directed to alexithymia. Future controlled studies should examine whether these improvements of alexithymia are due to psychotherapeutic interventions, in particular exposure therapy.