Alexithymia as a possible specifier of adverse outcomes: Clinical correlates in euthymic unipolar individuals

Gianluca Serafini, Domenico De Berardis, Alessandro Valchera, Giovanna Canepa, Pierre A. Geoffroy, Maurizio Pompili, Mario Amore

Research output: Contribution to journalArticlepeer-review


Background: Alexithymia is a disabling condition frequently linked to major depressive disorder (MDD) and able to enhance symptoms severity and suicide risk. This study aimed to clarify whether patients with and without alexithymia may differ concerning illness presentation and clinical course, which is a major gap in the scientific literature. Methods: The present sample included 381 euthymic outpatients with MDD recruited at the Department of Neuroscience (DINOGMI), University of Genoa. The Toronto Alexithymia Scale (TAS-20) and additional rating scales (Clinical Global Impression (CGI), Hamilton Anxiety Rating Scale (HAM-A), Intent Score Scale (ISS) were administered to all participants. Results: Alexithymic patients were more likely to have lower educational level (11.6 ± 3.2 vs. 12.4 ± 3.4, p ≤.05), have used previous psychiatric drugs (85.7% vs. 72.8%, p =.001), use current antidepressants (84.7% vs. 69.4%, p = <.001), and have higher cardiological comorbid disorders (10.7% vs. 5.0%, p = ≤.05). After multivariate analyses, alexithymia was associated with lower educational level (OR=0.928, p =.05), and higher current antidepressants use (OR 2.302, p =.01); difficulties in identifying feelings were associated with lower educational level (p = ≤.005), higher psychiatric comorbidity (p = ≤.001), and previous psychiatric medications (p =.01). Furthermore, having a lower educational level remained the only factor associated with both difficulties in communicating feelings (p = ≤.001) and thoughts oriented to external context (p = ≤.005). Limitations: The study is limited by the small sample size and its cross-sectional nature. Conclusions: Alexithymia appears a useful specifier of adverse outcomes, associated with distinct socio-demographic and clinical characteristics. Its identification would allow to provide a more personalized care.

Original languageEnglish
Pages (from-to)428-436
Number of pages9
JournalJournal of Affective Disorders
Publication statusPublished - Feb 15 2020


  • Alexithymia
  • Difficulties in communicating feelings
  • Difficulties in identifying feelings
  • Thoughts oriented to external context
  • Unipolar depression]

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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