Predicting symptoms in major depression after inpatient treatment: the role of alexithymia
Sammanfattning
Alexithymia has been considered to have a negative influence on the course of symptoms in
various psychiatric disorders. Only a few studies of depressed patients have examined whether
alexithymia predicts the outcome of therapeutic interventions or the course of symptoms in
naturalistic settings. This prospective study investigated whether alexithymia is associated with
depressive symptoms after a multimodal inpatient treatment. Forty-five inpatients suffering from
acute major depression were examined in the initial phase of treatment and then again after seven
weeks. Patients took part in a multimodal treatment programme comprising psychodynamic-
interactional oriented individual and group therapy. The majority of patients were taking
antidepressants during study participation. To assess alexithymia and depressive symptoms, the
20-item Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory II (BDI-II) and the
Hamilton Depression Scale (HAMD) were administered at baseline and follow-up. When controlling
for baseline depressive symptoms along with trait anxiety, high scores in the externally oriented
thinking (EOT) facet of alexithymia at baseline predicted high severity of depressive symptoms at
follow-up (for self-reported as well as interviewer-based scores). Inpatients suffering from major
depression with a more pronounced external cognitive style might benefit less from a routine
multimodal treatment approach (including psychodynamic interactional therapy, antidepressant
medication, and complementary therapies). Intervention programmes might modify or account for
alexithymic characteristics to improve the course of depressive symptoms in these patients.