An evaluation of the absolute and relative stability of alexithymia over 11years in a Finnish general population.

OBJECTIVE: We investigated if alexithymia, a personality construct with difficulties in emotional processing, is stable in the general population. METHODS: Altogether 3083 unselected subjects aged 30 and older in Finland completed the 20-item Toronto Alexithymia Scale (TAS-20) in the longitudinal Health 2000 and Health 2011 general population surveys (BRIF8901). The stability of alexithymia at the 11-year follow-up was assessed with t-tests, correlations, and separate linear regression models with base-line and follow-up age, gender, marital status, education, and 12-month depressive and anxiety disorders as confounders. RESULTS: The mean score (SD) of the TAS-20 for the whole sample was 44.2 (10.4) in 2000 and 44.2 (10.9) in 2011 (p=0.731). The mean score of the TAS-20 subscale Difficulty Identifying Feelings increased by 0.3 points, Difficulty Describing Feelings decreased by 0.6 points and Externally Oriented Thinking increased by 0.3 points. The effect sizes of the changes varied from negligible to small. Age had little effect except for the group of the oldest subjects (75-97years): the TAS-20 mean (SD) score was 49.1 (10.1) in 2000 and 53.1 (10.3) in 2011 (p<0.001), the effect size for the increase was medium. TAS-20 score in 2000 explained a significant proportion of variance in TAS-20 score in 2011. Controlling for all baseline confounders improved the model incrementally; the same applied to controlling for confounders at follow-up. Baseline depression or anxiety disorders were not associated with the TAS-20 scores in 2011, whereas current diagnoses were. CONCLUSIONS: According to our large longitudinal study both the absolute and relative stability of alexithymia assessed with the TAS-20 are high in the adult general population.

No association between serotonin 5-HT 1A receptors and spirituality among patients with major depressive disorders or healthy volunteers.

An earlier study (Borg et al., Am J Psychiatry 2003) found an inverse correlation between [carbonyl-(11)C]WAY-100635 ligand binding to 5-HT(1A) receptors and scores for self-transcendence, but no other of the six dimensions of the Temperament and Character Inventory, in a group of healthy males. The aim of this study was to investigate if the finding of an inverse correlation between spirituality and 5-HT(1A) could be seen in patients suffering from major depressive disorder or replicated among healthy volunteers. A total of 23 patients with major depressive disorder and 20 healthy volunteers were examined with PET using [carbonyl-(11)C]WAY-100635 as the radioligand. The personality traits were measured using the Finnish version of the Temperament and Character Inventory and correlated with ligand binding (BP). No significant correlations were found between the different Temperament and Character Inventory subscales and BP in any of the studied brain regions (amygdala, anterior cingulate cortex, dorsal raphe nuclei, dorsolateral prefrontal cortex, angular gyrus, inferior, middle, and superior temporal gyri, medial prefrontal cortex orbitofrontal cortex, hippocampus, insular cortex, subgenual anterior cingulate cortex, supramarginal gyrus, ventrolateral prefrontal cortex, and posterior cingulate cortex). These results do not support the idea that the serotonin system forms the biological basis of spiritual experiences among patients suffering from major depressive disorder or among healthy volunteers.

Alexithymia behaves as a personality trait over a 5-year period in Finnish general population.

OBJECTIVE: Temporal stability is a basic assumption underlying any personality trait construct. Previous research on the stability of alexithymia has led to a controversy over whether alexithymia should be viewed as a state-dependent phenomenon or as a stable personality trait. The aim of this 5-year longitudinal study was to examine the temporal stability of alexithymia in the general population in Finland. METHODS: Alexithymia was measured with the 20-Item Toronto Alexithymia Scale (TAS-20) at the baseline and 5 years later. RESULTS: The test-retest correlations of the TAS-20 total and factor-specific scores at the baseline and at the 5-year follow-up ranged from moderate to high in both genders, reflecting a rather high relative stability of the TAS-20 scores over a period of 5 years. CONCLUSIONS: The findings of our study suggest that alexithymia behaves like a stable personality trait in the general population.

Temporal stability of alexithymia over a five-year period in outpatients with major depression.

BACKGROUND: Previous research on alexithymia and depression has led to a controversy over whether alexithymia should be viewed as a state-dependent phenomenon or as a stable personality trait. The aim of this 5-year follow-up study was to examine the temporal stability of alexithymia in outpatients suffering from major depression. METHODS: The study population comprised 116 (49 male and 67 female) outpatients with major depression. Alexithymic features were assessed with the Toronto Alexithymia Scale (TAS-20) and the degree of depression with the Beck Depression Inventory. The patients were retested after a period of 5 years. RESULTS: Mean alexithymia and depression scores decreased significantly over the 5-year period. Alexithymia and depression were associated with each other, but the high test-retest correlations in the TAS-20 scores indicate relative stability of alexithymia. The three factors of alexithymia behaved differently. Difficulty in identifying feelings and difficulty in describing feelings were associated with alleviation of depressive symptoms, whereas externally oriented thinking was not. CONCLUSIONS: Alexithymia seems to be related with the severity of depression in outpatients with major depression, but it also shows relative stability over 5 years. Our findings support the view that the alexithymia construct represents a stable personality trait, but is also a state-dependent phenomenon.

Inadequate treatment of depression after myocardial infarction.

OBJECTIVE: The objective of the study was to investigate the prevalence of depressive symptoms and the self-reported psychiatric treatment after myocardial infarction. METHOD: Depressive symptoms and medication were studied in 85 consecutive acute myocardial infarction patients during 18 months follow-up. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). RESULTS: The proportion of patients with depressive symptoms (BDI >/= 10) was 21.2% while in hospital, 30.0% at 6 months and 33.9% at 18 months. At 18 months, none of the patients were receiving adequate antidepressive medication. There were eight patients with BDI scores corresponding to moderate/severe depression (BDI >/= 19). Six of these patients were receiving benzodiazepine medication and two of them had been treated in the mental health care system after the myocardial infarction. CONCLUSION: There seems to be considerable problems in the diagnosis and/or treatment of depression after myocardial infarction.

Alexithymia and depression: a 1-year follow-up study in outpatients with major depression.

OBJECTIVE: To examine the changes in alexithymic features and depressive and other psychological distress symptoms during a 1-year follow-up among patients with major depression. METHODS: The study population comprised 120 outpatients suffering from major depression. Diagnosis was made with Structured Clinical Interview (SCID-I) for DSM-III-R. The severity of depression was evaluated with the 17-item Hamilton Rating Scale for Depression (HAM-D), and self-reported depression with the Beck Depression Inventory (BDI-21). Alexithymic features were assessed with the Twenty-Item Toronto Alexithymia Scale (TAS-20). Self-reported psychological distress symptoms were evaluated with the Brief Symptom Inventory (BSI). RESULTS: Measures of depression and distress were significantly lower at the follow-up than at the baseline, while the total TAS-20 scores did not change significantly during the follow-up. A closer examination revealed that various TAS-20 factors behaved differently. Changes in Factors 1 and 2 were associated with changes in mood, whereas those in Factor 3 were not. Additionally, recovery from depression was associated with decrease in alexithymic features. CONCLUSION: Difficulties in identifying and in describing feelings are associated with changes in mood, while externally oriented thinking is not.

Alexithymia: a facet of essential hypertension.

Two hundred thirty-seven newly diagnosed yet untreated hypertensive men and women, 35 to 54 years of age, were compared with an age- and gender-stratified random population sample of 146 normotensive men and women to find out whether psychological distress symptoms, anger expression, and alexithymia are associated with elevated blood pressure and whether the possible associations are independent of sodium and alcohol intake, body mass index, and physical fitness. The independent attributes of mean arterial pressure were studied by multivariate regression analyses after combining the subjects in the hypertensive and control groups. Three questionnaires were used: the Brief Symptom Inventory (BSI-37), a 31-item version of the Spielberger State-Trait Anger Expression Inventory (STAXI), and the Toronto Alexithymia Scale (TAS-26). Total scores of the TAS-26 were higher (P<0.001) in hypertensive men and women than in their normotensive control subjects (75.6+/-7.8 vs 64.1+/-9.8 in men and 72.9+/-7.1 vs 57.5+/-11.5 in women). There were no differences between the study and control groups in psychological distress symptoms, including anxiety, depression, and hostility, or in anger expression. In multivariate regression analyses, higher age, male gender, higher sodium intake, lower physical fitness, and alexithymia were independently and highly significantly (P<0.01 for male gender, P<0.0001 for other variables) associated with increased blood pressure, explaining altogether 39.5% of the cross-sectional variation in mean arterial pressure. We conclude that alexithymia, that is, poor ability to experience and express emotions, is associated with elevated blood pressure independent of sodium and alcohol intake, body mass index, and physical fitness.

Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland.

The prevalence of alexithymia and its association with sociodemographic variables were studied in a sample of 1285 subjects representing the general population of Finland. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). Alexithymia was normally distributed in the population in both genders, confirming that it is a personality dimension. The prevalence of alexithymia was 13%. Men were alexithymic almost twice (17%) as often as women (10%). Multivariate analysis showed that alexithymia was associated with male gender, advanced age, low educational level, and low socioeconomic status. As to the three factors of the TAS-20, men scored higher in factors 2 (difficulty in describing feelings) and 3 (externally oriented thinking). but there was no gender difference in factor 1 (difficulty in identifying feelings). Comparative population studies in other countries are needed to find out whether there are any differences in the prevalence of alexithymia between cultures.

Alexithymic features do not predict compliance with psychotherapy in consultation-liaison patients.

A 1-year follow-up study on 54 general hospital psychiatric consultation outpatients was carried out in order to determine whether alexithymic features, measured by the Toronto Alexithymia Scale (TAS) are predictive of psychotherapy recommendations and whether alexithymia is associated with patients' compliance with these recommendations. Contrary to what we expected, the presence of alexithymic features predicted neither treatment recommendations nor compliance. Psychological distress as measured by the Brief Symptom Inventory (BSI) proved to be a better predictor.

Depression and disability pension in Finland.

During the period 1987-1994 there has been a threefold increase in disability pensions granted to individuals with affective disorders in Finland. Possible reasons for this development include a deep economic recession, changes in the diagnostic system, and better recognition of affective disorders. Against this background, it seems relevant to ask why, over the same period, the functional capacity of depressive patients has markedly deteriorated, causing an increase in disability pensions, despite the fact that many new drugs and other treatments have become available.

Alexithymia--state or trait? One-year follow-up study of general hospital psychiatric consultation out-patients.

We carried out a 1-year follow-up study on 54 out of 80 general hospital psychiatric consultation out-patients. Alexithymic features were measured by the Toronto Alexithymia Scale (TAS), and self-reported psychological distress with the Brief Symptom Inventory (BSI). Men were more alexithymic and distressed than women both at the baseline and at the follow-up evaluations. The degree of alexithymia in both genders remained consistent, whereas psychological distress decreased significantly in both genders during the follow-up period. Therefore we conclude that alexithymia presents a constant trait in psychiatric consultation out-patients.

Alexithymia in psychiatric consultation-liaison patients.

Alexithymic characteristics were assessed by the Toronto Alexithymia Scale (TAS), a self-report measure of alexithymia, in 230 consecutive outpatients referred to a psychiatric consultation-liaison service. The prevalence of alexithymia was 37.8% (50.5% in men and 28.2% in women). Alexithymia was significantly associated with the following variables: male gender, low socioeconomic status, the presence of psychiatric disorder, especially depression, with old age and with a high level of psychological distress. No significant association between alexithymia and the presence of somatic illness was found.

Depression and the dexamethasone suppression test (DST) in patients with non-specific somatic complaints. Atypical depression and DST.

Non-suppression of the hypothalamic-pituitary-adrenocortical activity on the dexamethasone suppression test was found in 27/115 patients who were referred to consulting psychiatrists in the Psychiatric Outpatient Clinic of Turku University Central Hospital and in the Rehabilitation Research Centre because of unspecific chronic pain complaints. Depressive symptoms in the patients were identified by the Research Diagnostic Criteria for definite or probable endogenous and non-endogenous depressive disorders. The cortisol levels after dexamethasone suppression were significantly higher in endogenous than in non-endogenous patients and it uncovered masked depression in some complex patients. However, nonsuppression in the dexamethasone suppression test was not specifically associated with the pain-prone disorder, which was further characterized by the factor models of the Hamilton Depression Scale.

Psychosomatic disorder: a treatment problem more difficult than neurosis? A comparative clinical study of psychosomatic and neurotic patients of the psychiatric policlinic of a general hospital.

Two patient groups from the psychiatric policlinic of a general hospital were compared, the first comprised 93 patients with severe psychosomatic disorders who were not diagnosed as neurotic, and the second, 133 neurotic patients without psychosomatic symptoms. The aim of the study was to clarify anamnestic and personality differences between the groups and investigate their treatment motivation. The psychosomatic patients showed less motivation for psychiatric treatment, even though their psychiatric impairment was more severe than that of the neurotics and although the extent of their psychological symptoms was equally great. Compared with the neurotic patients, the ability to tolerate stress was poorer and the attitude toward the interview and the interviewer was more defensive in the psychosomatic patients. Compared with the neurotics, medical services were utilized to a greater extent by the psychosomatic patients, and their childhood environment and background development were characterized by somewhat more psychological disturbance.