Alexithymia in social anxiety disorder: is there a specific relationship or is it a feature of comorbid major depression?

Abstract

Objective: Alexithymia has been extensively studied in the literature regarding its relationship with major depression. However, patients with anxiety related problems also have high alexithymic traits. Our study aimed to assess the presence of alexithymia and clinical variables associated with it in a specific subset of patients with anxiety, namely social anxiety disorder (SAD). Methods: 140 patients with generalized type SAD were assessed by using Toronto Alexithymia Scale-20 (TAS-20), Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Global Assessment of Functioning Scale (GAF). Participants with TAS-20 scores >= 61 were considered as alexithymic and they were compared with non-alexithymic (TAS-20 <61) participants in terms of rating scale scores, clinical characteristics and comorbidity profiles. Results: 46 patients were alexithymic (32.9%) and 94 patients constituted the non-alexithymic group. In comparisons between the two groups, alexithymic group was characterized by a lower mean age at onset of SAD, higher BDI, BAI, LSAS scores and total number of comorbid diagnoses and lower mean current and previous year GAF scores. However, there appears to be a weaker relationship between SAD and alexithymia after controlling for depression. Discussion: Our results suggest that alexithymia is associated with a more severe symptomatology, higher comorbidity and functional impairment in patients with SAD. However, this association may be stronger in patients who have current comorbid major depression than in other patients with SAD.