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: 3.69). 11/2008; 32(8):1982-6. DOI: 10.1016/j.pnpbp.2008.09.022
Source: PubMed


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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Available from: Domenico De Berardis
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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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    ABSTRACT: Objective: To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria. Method: Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis. Results: Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%). Conclusions: The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seem to be deceptively similar since they share the same psychiatric and/or medical diagnosis.
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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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