The effect of alexithymic features on response to antidepressant medication in patients with major depression

Abstract

There has been no follow-up study regarding the effect of alexithymic features on antidepressant treatment. This study was planned to observe whether alexithymia effects short-term treatment outcome in depression. The study included 32 alexithymic and 33 nonalexithymic outpatients with major depression. Depression was assessed on the basis of the Structured Clinical Interview for DSM-IV (SCID-I). Level of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAM-D). Alexithymia was screened using the Turkish version of Toronto Alexithymia Scale (TAS-20). All patients received 20 mg/d paroxetine for 10 weeks. Alexithymic and nonalexithymic patients were compared on the HAM-D scores, TAS-20 scores, and rate of response to antidepressant medication. The rate of responders, defined by a reduction of >50% from baseline in HAM-D total score, was 21.9% in the alexithymic group and 54.5% in the nonalexithymic group. Changes in the HAM-D scores were significantly correlated with the TAS-20 scores. TAS-20 scores dropped below 61 in only 31.2% of the alexithymic patients, and 68.8% of patients remained alexithymic. Whereas 50% of patients whose TAS-20 scores dropped below 61 responded to antidepressant medication, this rate was only 9.1% among patients who remained alexithymic. These findings indicated that the stability of alexithymic features had a negative effect on antidepressant treatment in depression.

Is alexithymia a risk factor for major depression, personality disorder, or alcohol use disorders? A prospective population-based study

“…Earlier studies [5,9,25] have suggested that alexithymia in depressed patients might be alleviated during recovery from depression. Similarly, a recent study among pregnant women showed that although TAS scores did not predict depression, they increased during depression and decreased after remission [26].…”

Associations of perceived pain and painless TMD‐related symptoms with alexithymia and depressive mood in media personnel with or without irregular shift work

“…Moreover, alexithymia seems to have some influence on treatment responses (32). One theory for a causal relationship between alexithymia and psychosomatic illnesses, for example, is that alexithymics may lack the so-called affective awareness which would permit identification of a particular situation as stressful, and they therefore experience stressful events longer and more frequently than non-alexithymics; this, in turn, may lead to a cascade of increased or excessive sympathetic activity, tissue damage, and pain (33).…”

Alexithymic Depression: Evidence for a Depression Subtype?

“…Clinically oriented research suggests that alexithymic depressed patients constitute a specific group: irrespective of the degree of depression, they have more suicidal ideation [9] , more somatic symptoms of distress [10] and respond significantly less well to the antidepressant medication paroxetine than nonalexithymic depressed patients [11] . A categorical distinction has also been suggested by clinicians who discriminate between primary and secondary depression [12] or between essential and psychoneurotic depression [13] .…”