Is Alexithymia Related to Negative Symptoms of Schizophrenia?

Background: Alexithymic features are close to anhedonia, blunted affect, and alogia that are also characteristics of the negative symptoms of schizophrenia. This study aimed to evaluate whether alexithymia is associated with negative symptoms and is related to the change of schizophrenic symptoms over time. Sampling and Methods: A consecutive sample of 29 schizophrenic outpatients was evaluated at baseline and at 3, 6, and 12 months during appropriate treatment. They completed the Positive and Negative Syndrome Scale, the Montgomery and Asberg Depression Rating Scale, the Global Assessment of Functioning Scale, and the 20-item Toronto Alexithymia Scale at any time points. Results: The psychiatric scale scores showed significant symptom improvement over time but were unrelated to the alexithymia score that was instead stable over time. Hierarchical regression showed that the 20-item Toronto Alexithymia Scale at baseline was the sole predictor of alexithymia at 12 months, after controlling for psychopathology and psychological functioning. Conclusions: Alexithymia was unrelated to negative symptoms, suggesting it is an independent and separate construct from schizophrenia. As expected, the negative symptoms were associated instead with illness-related aspects of depression and psychosocial functioning. Caution should be expressed in generalization mainly because this study is limited by the small sample size.

[1]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[2]  G J Taylor,et al.  Alexithymia and the recognition of facial expressions of emotion. , 1993, Psychotherapy and psychosomatics.

[3]  Markus Bühner,et al.  Is there a reliable factorial structure in the 20-item Toronto Alexithymia Scale? A comparison of factor models in clinical and normal adult samples. , 2003, Journal of psychosomatic research.

[4]  P. Näätänen,et al.  The Influence of Alexithymic Characteristics on the Self-Perception and Facial Expression of a Physiological Stress State , 1999, Psychotherapy and Psychosomatics.

[5]  M. Åsberg,et al.  A New Depression Scale Designed to be Sensitive to Change , 1979, British Journal of Psychiatry.

[6]  I. Nyklíček,et al.  Alexithymia: 25 years of theory and research , 2004 .

[7]  M. Harrow,et al.  The course of anhedonia during 10 years of schizophrenic illness. , 2002, Journal of abnormal psychology.

[8]  A. Kokoszka,et al.  Alexithymia in Schizophrenia: An Exploratory Study , 2001, Psychological reports.

[9]  Nancy C. Andreasen,et al.  Negative Versus Positive Schizophrenia , 1991, Springer Berlin Heidelberg.

[10]  G. Taylor.  Recent Developments in Alexithymia Theory and Research , 2000, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[11]  C. Maggini,et al.  Subjective Experience of Language Impairment and Psychopathology in Schizophrenia , 2003, Psychopathology.

[12]  R. Bagby,et al.  The 20-Item Toronto Alexithymia Scale: IV. Reliability and factorial validity in different languages and cultures , 2003 .

[13]  V. Ricca,et al.  Alexithymia and schizophrenias. , 1995, Psychopathology.

[14]  M. Lumley.  Alexithymia and negative emotional conditions. , 2000, Journal of psychosomatic research.

[15]  R. Lane,et al.  Impaired Verbal and Nonverbal Emotion Recognition in Alexithymia , 1996, Psychosomatic medicine.

[16]  P E Sifneos,et al.  The prevalence of 'alexithymic' characteristics in psychosomatic patients. , 1973, Psychotherapy and psychosomatics.

[17]  S. Dollfus,et al.  [Negative symptoms, depression, anxiety and alexithymia in DSM III-R schizophrenic patients]. , 1997, L'Encephale.

[18]  C. Maggini,et al.  Depersonalization and Basic Symptoms in Schizophrenia , 2002, Psychopathology.

[19]  R. Bagby,et al.  The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. , 1994, Journal of psychosomatic research.

[20]  B. Bermond,et al.  Validity and reliability of the Bermond–Vorst Alexithymia Questionnaire , 2001 .

[21]  D. Romney,et al.  Anhedonia in Depression and Schizophrenia: A Reexamination , 2001, The Journal of nervous and mental disease.

[22]  R. Bagby,et al.  New Trends in Alexithymia Research , 2004, Psychotherapy and Psychosomatics.

[23]  G J Taylor,et al.  The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. , 1994, Journal of psychosomatic research.

[24]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[25]  N C Andreasen,et al.  Negative v positive schizophrenia. Definition and validation. , 1982, Archives of general psychiatry.

[26]  P. Boyer,et al.  Anhedonia and negative symptomatology in chronic schizophrenia. , 1996, Comprehensive psychiatry.

[27]  J BELBEY,et al.  What is schizophrenia? , 1982, Schizophrenia bulletin.

[28]  Graeme J. Taylor,et al.  Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness , 1999 .

[29]  P. Spinhoven,et al.  The assessment of alexithymia: a critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20. , 2002, Journal of psychosomatic research.

[30]  S. Dollfus,et al.  [Alexithymia in negative symptom and non-negative symptom schizophrenia]. , 1997, L'Encephale.