Predictive value of alexithymia in patients with eating disorders: a 3-year prospective study.
OBJECTIVE
Several cross-sectional studies have reported high levels of alexithymia in populations with eating disorders. However, only few studies, fraught with multiple methodological biases, have assessed the prognostic value of alexithymic features in these disorders. The aim of the present study was to investigate the long-term prognostic value of alexithymic features in a sample of patients with eating disorders.


METHODS
Within the framework of a European research project on eating disorders (INSERM Network No. 494013), we conducted a 3-year longitudinal study exploring a sample of 102 DSM-IV eating disorder patients using the Toronto Alexithymia Scale (TAS-20) and the Beck Depression Inventory.


RESULTS
At the 3-year assessment, 74% (n=76) of the sample still presented a syndromal or subsyndromal eating disorder (unfavorable outcome: score of > or =3 on the Psychiatric Status Rating Scale for anorexia nervosa or bulimia nervosa). In logistic and hierarchical regression analyses, the Difficulty Identifying Feelings factor of the TAS-20 emerged as a significant predictor of treatment outcome, independent of depressive symptoms and eating disorder severity.


CONCLUSIONS
The results of this study indicate that difficulty in identifying feelings can act as a negative prognostic factor of the long-term outcome of patients with eating disorders. Professionals should carefully monitor emotional identification and expression in patients with eating disorders and develop specific strategies to encourage labeling and sharing of emotions.
Speranza
Mario
M
Department of Child Psychiatry, Centre Hospitalier de Versailes, Versailes, France. mario.speranza@noos.fr
Loas
Gwenolé
G
Wallier
Jenny
J
Corcos
Maurice
M
D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index