Secondary alexithymia as a state reaction in panic disorder and social phobia

105

Background: In the present study, we evaluated whether patients with panic disorder (PD) in complete remission were more alexithymic than normal controls. Methods: Fifty-two PD patients (both during the acute phase of the disorder and after at least 2 months of complete remission) and 52 age- and sex-matched normal subjects completed the Toronto Alexithymia Scale-20 and the Hamilton Rating Scales for Anxiety (Ham-A) and for Depression. Results: A higher rate of alexithymia was found in PD patients than in controls (3.8%) both during the acute phase (44.2%; p < 0.001) and after remission of the disorder (21.2%; p = 0.008). During remission, PD patients showed: (1) Ham-A scores significantly higher than controls (p < 0.001); (2) only an elevation of the ‘difficulty in identifying feeling’ (DIF) dimension of alexithymia, and (3) a positive relationship between Ham-A scores and DIF levels (p < 0.001). Conclusion: After remission of panic attacks, phobic avoidance and anticipatory anxiety, PD patients are more alexithymic (even though the levels of alexithymia decreased after the resolution of the acute phase of PD) and anxious than controls. This finding might be explained by an overlap between cognitive aspects of PD and the DIF dimension of alexithymia, since alexithymic and anxious levels are positively related.

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Relationship between Alexithymia and Panic Disorder: A Longitudinal Study to Answer an Open Question

Marchesi

Fontò

Balista

et al. 2004

105

“…Therefore we could not statistically control for the effects of anxiety and depression on the alexithymia scores. Recent research has shown that anxiety and depression are associated with alexithymia [32, 33, 34] as well as with a primitive defense style [35, 36, 37], anger and somatization [38, 39, 40]. Consequently, we cannot exclude the possibility that the strong association between a primitive defense style and alexithymia is state-dependent.…”

Section: Discussionmentioning

confidence: 95%

Perceived Parental Attitude, Alexithymia and Defense Style in Psychiatric Outpatients

Kooiman

Spinhoven

Trijsburg

et al. 1998

Background: Although it is the clinical impression that alexithymia may be due to disturbances in the early parent-child relationship and that it is associated with primitive defense mechanisms, a possible association with neurotic defense mechanisms, such as repression and reaction formation, has also been mentioned. However, empirical studies on these and related issues are scarce. The aim of this study was to determine the association between perceived parental attitude, defense mechanisms and alexithymia. Methods: In a cross-sectional study we obtained data from 78 psychiatric outpatients. Alexithymia, defense mechanisms and perceived parental attitude were measured with the Toronto Alexithymia Scale, the Defense Style Questionnaire and the Parental Bonding Instrument. Results: We found only weak associations between perceived parental attitude and alexithymic features. Primitive and adaptive defenses were associated with alexithymic features in a clinically sensible way. The strongest association was found between primitive defense mechanisms and alexithymic features. There was hardly any association between neurotic defense mechanisms and alexithymic features. Conclusions: The results of our study support the hypothesis that alexithymia is associated with a primitive defense style, whereas a relation to disturbances in early parent-child relationship could not be confirmed. It is argued that possibly more severe traumatic experiences, such as physical and sexual abuse, than merely a negatively perceived parental attitude, are necessary to develop alexithymic features.

“…In a follow-up study of patients with panic disorder or social phobia, Fukunishi et al [21]found that alexithymic features can be reduced by using psychiatric treatment that is designed to treat anxiety. We found that benzodiazepine medication may have a beneficial effect in alexithymic patients with depressive disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Although a number of follow-up studies have examined the stability of alexithymia [6, 11, 19, 20, 21, 22], none of these have specifically focused on clinically depressed patients. So far, only one short-term follow-up study has investigated patients with depressive disorders [23].…”

Section: Introductionmentioning

confidence: 99%

Is Alexithymia a Permanent Feature in Depressed Patients?

Honkalampi

Hintikka

Saarinen

et al. 2000

138

Background: A six-month follow-up study was conducted to determine whether alexithymia is a permanent feature in 169 depressed outpatients. Methods: Diagnosis of depression was confirmed by means of the Structured Clinical Interview for DSM-III-R (SCID-I). Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale (TAS-20) and severity of depression was assessed using the 21-item Beck Depression Inventory (BDI). Results: Almost 40% of the patients were considered alexithymic at baseline, but only 23% at follow-up. Alexithymic patients were more often moderately or severely depressed than other patients in both study phases. The BDI scores explained 23% (at baseline) and 42% (at follow-up) of the variation in TAS-20 scores. The decrease in the TAS-20 scores was associated with a concurrent decrease in BDI scores. Conclusions: Alexithymic patients with depressive disorders do not appear to form a stable group. On the contrary, alexithymia seems to change as a function of depression. In the light of these results, alexithymia appears not to be a stable personality trait among depressed patients, and furthermore, it seems possible that alexithymic features respond to psychiatric treatment.