Article

Alexithymia and its relationships with C-reactive protein and serum lipid levels among drug naïve adult outpatients with major depression

Department of Oncology and Neurosciences, Institute of Psychiatry, University G. d'Annunzio of Chieti, Italy.
Progress in Neuro-Psychopharmacology and Biological Psychiatry (Impact Factor: 4.03). 11/2008; 32(8):1982-6. DOI: 10.1016/j.pnpbp.2008.09.022
Source: PubMed

ABSTRACT Several studies have investigated the relationship between C-reactive protein (CRP) and serum lipid levels in Major Depression (MD), but no study has, to date, evaluated the impact of alexithymia on these parameters. Therefore, the aim of the present cross-sectional study was to evaluate the relationship between alexithymia, suicide risk, C-reactive protein (CRP) and serum lipid levels in adult outpatients suffering from moderate to severe MD. CRP and serum lipid levels data were analyzed in 145 drug-naïve adult outpatients (69 men, 76 women) with a DSM-IV diagnosis of MD. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), depression severity was evaluated with the 17-item Hamilton Depression Rating Scale (HAM-D) and suicide risk was determined using the Scale of Suicide Ideation (SSI). Alexithymics showed altered serum lipid levels and higher CRP than non-alexithymics. In the linear regression models, lower total cholesterol levels and "Difficulty in Identifying Feelings" dimension of TAS-20 were significantly associated with depression severity, whereas lower high-density lipoprotein levels and "Difficulty in Identifying and Describing Feelings" dimensions of TAS-20 were associated with higher suicide risk. Authors discuss study limitations and future research needs.

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    • "Major depressive disorder is one of the most disabling and common psychiatric disorders. Recent data estimate a lifetime prevalence of MDD at 16.6% and the one-year prevalence at 6.7% [113–116]. MDD is a leading cause of premature death and ongoing disability [117,118]. Psychopharmacological treatments include a number of antidepressant drugs; however, over 60% of treated patients respond unsatisfactorily, and almost 20% of patients become refractory to the treatments [119–121]. "
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    • "In a survey on general population, alexithymia was independently predicted by higher levels of C-reactive protein (CRP), even after controlling for age, sex, lifestyle (body mass index, smoking, alcohol), comorbidity for chronic diseases, and use of anti-inflammatory medications [55]. Consistently, in drugnaïve depressed outpatients, higher levels of alexithymia were significantly associated with altered serum lipid levels (particularly total cholesterol and high-density lipoprotein) and higher CRP [56]. In a large survey of general population [57], alexithymia was associated with hypertension and carotid atherosclerosis, independently of any mediating variables. "
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    • "The role of serum lipid levels in neuropsychiatric disorders has been widely investigated [20] [21] [22] [23]. There are some data that suggest that serum lipid composition may be altered in PD patients than normal controls [24] [25] [26] [27], but, to date, findings are somewhat inconsistent. "
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    ABSTRACT: To elucidate the relationships between alexithymia, suicide ideation and serum lipid levels in drug-naïve adult outpatients with a DSM-IV diagnosis of Panic Disorder (PD), 72 patients were evaluated. Measures were the Panic Attack and Anticipatory Anxiety Scale, the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI) and the Montgomery Åsberg Depression Rating Scale (MADRS). Alexithymic patients showed higher scores on all rating scales and altered serum lipid levels than non-alexithymics. In the hierarchical regression model, the presence of lower HDL-C and higher VLDL-C levels and Difficulty in Identifying Feelings dimension of TAS-20 were associated with higher suicide ideation. In conclusion, alexithymic individuals with PD may show a cholesterol dysregulation that may be linked to suicide ideation. The authors discuss study limitations and future research needs.
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