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Alexithymia as a predictor of residual symptoms in depressed patients who respond to short-term psychotherapy.

Residual symptoms are increasingly becoming recognized as an important problem in the treatment of major depression. It is unclear which individuals are more likely to suffer from residual symptoms following treatment. This study investigated the role of alexithymia in the prediction of residual symptoms following treatment with psychotherapy. The study utilized data from 33 outpatients with major depression who were positive responders to psychotherapy. Alexithymia was assessed prior to treatment using the 20-item Toronto Alexithymia Scale. Depressive and anxious symptomatology were assessed using the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory, respectively. Alexithymia factor 1 (difficulty identifying feelings) was predictive of the severity of residual symptoms, over and above the effect of initial levels of depression and anxiety, form of psychotherapy, and use of antidepressant medication. The findings suggest that difficulty identifying feelings may constrain one's ability to effectively utilize psychotherapy, thereby contributing to the persistence of residual symptoms.