Is alexithymia associated with specific mental disorders?

BACKGROUND: Alexithymia is characterized by restrictions in the perception, differentiation and regulation of affects. It is considered to be an important vulnerability factor for the development of mental disorders. Little is known, however, of whether alexithymia is associated with specific mental disorders. SAMPLING AND METHODS: Data from 1,461 patients of an outpatient clinic for psychosomatic medicine with various mental disorders (depressive disorders, anxiety disorders, adjustment disorders, somatoform disorders, eating disorders, and psychological and behavioral factors of physical illness) were collected between January 2007 and October 2009. The 20-item Toronto Alexithymia Scale (TAS-20) was administered to study alexithymia. The diagnoses were made following ICD-10 guidelines. RESULTS: In our sample, the total prevalence of alexithymia (TAS-20 ≥ 61) was 21.36%. The percentage of alexithymic patients was significantly increased in the group of patients with depressive disorders (26.9%) as compared to other diagnostic groups. Using TAS-20 as a continuous measure, multiple hierarchical regression analyses revealed that higher TAS-20 total scores were significantly associated with depressive and anxiety disorders. However, after controlling for the level of depression, the association of anxiety disorders with alexithymia was no longer significant. With regard to TAS-20 subscales, 'difficulty describing feelings' (subscale 2) was also significantly related to depressive disorders. CONCLUSIONS: According to the results, the prevalence of alexithymia is relatively high in patients with mental disorders. The increased prevalence of highly alexithymic subjects suggests that alexithymia is associated with a higher vulnerability to mental illness. The prevalence of alexithymia was especially increased for depressive disorders. Thus, further evidence supporting the concept of 'alexithymic depression' was provided. From a therapeutic perspective, treatments should be developed that take the specific needs of highly alexithymic patients into account.

[Alexithymia and specific relationship patterns in a clinical sample]. / Alexithymie und spezifische Beziehungsmuster in einer klinischen Stichprobe.

OBJECTIVES: Alexithymia is characterized by deficits in perceiving, differentiating and regulating affects, both one's own affects and those of others. It is often related to interpersonal problems which are a major reason for seeking psychotherapy. This study assesses the relationship between alexithymia, specific relationship patterns and interpersonal problems in a clinical inpatient sample. METHODS: We evaluated alexithymia (Toronto-Alexithymia-Scale-26: TAS-26), relationship patterns (Relationship Patterns Questionnaire-II; RPQ-II) and interpersonal problems (Inventory of Interpersonal Problems: IIP) in 152 patients with various mental disorders upon admission to an inpatient clinic for psychosomatic medicine and psychotherapy. RESULTS: Alexithymia (TAS-20) was significantly negatively associated with self-assertion (RPQII) and significantly positively associated with overall interpersonal problems (IIP-total score). Specifically, the interpersonal style associated with alexithymia was characterized by cold, socially avoidant, nonassertive and exploitable behavior (IIP-subscales). CONCLUSIONS: Alexithymia in patients with mental disorders is linked to specific relationship patterns and interpersonal problems at the beginning of an inpatient psychotherapy. Because interpersonal problems, and especially the therapeutic alliance, are strong predictors of outcome in individual psychotherapy, specific attention should be paid to this relationship in the treatment of alexithymic patients.