Are treatment options related to alexithymia in eating disorders? Results from a three-year naturalistic longitudinal study.
OBJECTIVE
Longitudinal studies have shown that alexithymic features can interfere with treatment response in eating disorders. However, an alternative hypothesis could be that clinicians faced with alexithymic patients chose different treatment options according to their perceptions of these patients. The aim of this investigation was to explore the relationships between alexithymic features and treatment options provided by professionals in a naturalistic prospective study of eating disorders.


METHODS
We conducted a 3-year longitudinal study exploring a sample of 102 DSM-IV Eating Disorder patients with the Toronto Alexithymia Scale (TAS-20). All treatments received during follow-up were recorded and recoded dichotomously, and crossed with the variation of alexithymic categories (cut-off≥56) between inclusion and follow-up.


RESULTS
Patients received different treatments according to their alexithymic profile, in terms both of number and type of treatment received. Patients with high, stable levels of alexithymia received overall more treatments, and significantly more antidepressants, than non-alexithymic patients. Patients who became alexithymics during follow-up were more often rehospitalized and received fewer regular psychotherapies than the non-alexithymic patients.


CONCLUSIONS
Professionals should carefully monitor these personality features and be aware of the potential impact of alexithymic features on treatment compliance and on treatment choice for eating disordered patients.
Speranza
Mario
M
Inserm U669, Department of Child Psychiatry, université Paris-Sud, université Paris-V, centre hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France. mario.speranza@noos.fr
Loas
Gwenolé
G
Guilbaud
Olivier
O
Corcos
Maurice
M
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000150:complications* / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D010349:Patient Compliance; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods*; D055815:Young Adult
D000928:Antidepressive Agents