Baseline alexithymia and recovery from major depressive disorder: a longitudinal study

OBJECTIVE: To investigate whether alexithymia is associated with baseline symptom severity or longitudinal treatment outcomes in patients with major depressive disorder (MDD). METHODS: The sample comprised 258 outpatients with MDD (mean age = 31.77, SD = 11.30) followed for six months. Alexithymia was assessed with the Toronto Alexithymia Scale (TAS-20), depressive symptoms with the Beck Depression Inventory (BDI), and psychopathology with the SCL-90-R. RESULTS: = 23) at 6 months. Among patients with baseline alexithymia, 40.3% remained alexithymic at 3 months and 31.9% at 6 months. At baseline, alexithymic patients had significantly higher BDI scores and scores on all TAS-20 subscales and SCL-90-R domains. Depressive symptoms decreased significantly during follow-up, with the greatest improvement during the first 3 months. Although alexithymic patients had consistently higher depressive symptom levels, the time × group interaction was not significant, indicating similar improvement in both groups. However, participants with baseline alexithymia were significantly more likely to be lost to follow-up than those without alexithymia. CONCLUSION: Alexithymia was associated with greater baseline psychopathology and persistently higher depressive symptom levels. However, alexithymic and non-alexithymic patients showed similar trajectories of symptom reduction, suggesting that alexithymia does not limit improvement in depressive symptoms.