The role of alexithymia in predicting incident depression in patients at first acute coronary syndrome.
OBJECTIVE
Alexithymia has been considered both to predispose to depression and to worsen cardiac prognosis after an acute coronary syndrome. Nonetheless, no studies have evaluated its role as a risk factor for incident depression, in patients with acute coronary syndrome.


METHODS
In 251 consecutive patients, the presence of a first-ever depressive episode was evaluated with the Primary Care Evaluation of Mental Disorders at baseline and 1, 2, 4, 6, 9, 12 and 24 months after their first acute coronary syndrome. At baseline, patients completed the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale.


RESULTS
Out of 251 subjects (80.9% males), a first-ever depressive episode was diagnosed in 66 patients. Depressed and never-depressed patients differed in female gender, living status, alexithymic scores at TAS-20 and depressive symptoms. Nonetheless, nor the TAS-20 factors nor its total score were predictive of developing a depressive episode in a Cox regression. Moreover, baseline differences in TAS-20 scores between the two groups, disappeared after controlling for anhedonic symptoms.


CONCLUSIONS
Our results do not support the hypothesis that alexithymia at TAS-20 is a risk factor for incident depression after acute coronary syndrome.
Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy. Electronic address: carlo.marchesi@unipr.it.
Carlo
C
Marchesi
Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy. Electronic address: paolo.ossola@unipr.it.
Paolo
P
Ossola
Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy. Electronic address: scagnelli.fra@libero.it.
Francesca
F
Scagnelli
Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy. Electronic address: lorenzomellini@gmail.com.
Lorenzo
L
Mellini
Mental Health Department, AUSL, Parma, Italy. Electronic address: mtonna@ausl.pr.it.
Matteo
M
Tonna
Department of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. Electronic address: dardissino@ao.pr.it.
Diego
D
Ardissino
Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy. Electronic address: chiara.depanfilis@unipr.it.
Chiara
C
De Panfilis
D054058:Acute Coronary Syndrome / Q000523:psychology*; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors