title: Alexithymia and severe psychopathology: a study on psychiatric inpatients.
abstract: BACKGROUND
  The influence of severe psychopathology on alexithymic features has been poorly studied. This study aimed at investigating whether alexithymia is affected by the presence of psychosis and the severity of psychopathology.
  
  
  METHODS
  199 consecutive adult psychiatric inpatients, 60 of whom received a Structured Clinical Interview for DSM-IV Axis I diagnosis of psychotic disorder, were administered the 20-item Toronto Alexithymia Scale (TAS-20) and the 24-item Brief Psychiatric Rating Scale (BPRS). A random sample of 50 patients was reassessed at discharge. For all analyses, the Holm-Bonferroni correction was applied when appropriate to account for multiple testing.
  
  
  RESULTS
  The TAS-20 showed good internal consistency, acceptable relative stability, and good absolute stability both in patients with and without a psychotic disorder. Internal consistency and relative stability were higher in nonpsychotic than in psychotic patients. Mean TAS-20 score at admission did not differ between psychotic and nonpsychotic patients, and the TAS-20 score showed only a nonsignificant correlation (rho = 0.26) with BPRS score. Alexithymia at discharge was mostly explained (60%) by alexithymia at admission, while it was only modestly explained (4%) by BPRS scores at admission and discharge, with the latter being the only significant predictor. Changes in BPRS scores between admission and discharge explained a nonsignificant proportion (16%) of changes in TAS-20 scores and a moderate (21%) proportion of changes in difficulty identifying feelings.
  
  
  CONCLUSIONS
  Despite some limitations, these findings suggest that the severity of psychopathology and the presence of a psychotic disorder only modestly influence alexithymic characteristics, and that the TAS-20 may provide a reliable assessment of alexithymia in patients with severe psychopathology, except the most severely impaired ones.
authors.affiliation: Mental Health Unit, Centre of Epidemiology, Surveillance and Health Promotion, Italian National Institute of Health, Rome, Italy. angelo.picardi@iss.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Caroppo
authors.forename: Piero
authors.initials: P
authors.lastname: Porcelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Maria
authors.forename: Giampiero
authors.initials: G
authors.lastname: Munittola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index