Does psychotherapy improve alexithymia? A comparison study among patients with mild or moderate depression

Abstract Background Alexithymia is reported to be a risk factor for depression. Psychotherapy is efficient for treatment of depression. Yet, the effect of psychotherapies on alexithymia is poorly understood. Objectives We aimed to compare Cognitive Behavioral Therapy (CBT), Existential Psychotherapy (ExP) and Supportive Counseling (SUP) for therapeutic efficacy and effect on alexithymia in depression. Methods There were 22 patients for each patient group. Sessions were performed as eight consecutive weekly and following two monthly boosters. Sixty six healthy controls were added. Prior to the sessions, patients received Sociodemographic Data Form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), Hamilton Depression Rating Scale (HDRS) and 20-item Toronto Alexithymia Scale (TAS-20). The control group received Sociodemographic Data Form, SCID-1 and TAS-20. Patients additionally received HDRS and TAS-20 after their weekly and booster sessions. Results Patients’ mean TAS-20 score was greater than of controls, however, it did not have a significant change throughout the study. Mean HDRS scores of ExP and CBT groups were lower than SUP group at the end. Discussion Alexithymia did not improve with psychotherapy. The exception was effect of ExP on externally oriented thinking. Psychotherapies all improved depression. CBT and ExP were more helpful than SUP.

摘要
背景：有研究表明述情障碍（alexithymia）是抑郁症的危险因素。心理治疗对抑郁症的治疗具有良好效果，但现有研究对各类心理疗法改善述情障碍的作用效果仍缺乏充分了解。
目的：本研究旨在比较认知行为疗法（Cognitive Behavioral Therapy, CBT）、存在主义心理治疗（Existential Psychotherapy, ExP）与支持性咨询（Supportive Counseling, SUP）治疗抑郁症的临床疗效，及其对患者述情障碍的干预效果。
方法：本研究共设置3个患者干预组，每组各纳入22名受试者，干预方案为连续8周每周1次的治疗，后续辅以2次每月1次的强化随访治疗。另纳入66名健康对照受试者。干预开始前，所有患者需填写社会人口学问卷（Sociodemographic Data Form）、接受DSM-IV轴I障碍结构化临床访谈（Structured Clinical Interview for DSM-IV Axis I Disorders, SCID-1）、完成汉密尔顿抑郁量表（Hamilton Depression Rating Scale, HDRS）评定以及多伦多述情障碍量表20项版（20-item Toronto Alexithymia Scale, TAS-20）测评；对照组仅需填写社会人口学问卷、完成SCID-1访谈及TAS-20测评。患者在每次周度治疗及强化治疗结束后，需额外完成HDRS与TAS-20测评。
结果：患者组的TAS-20平均得分高于健康对照组，但在整个研究周期内未出现显著变化。研究结束时，ExP组与CBT组的HDRS平均得分均低于SUP组。
讨论：整体而言，常规心理治疗未能显著改善患者的述情障碍水平，但存在主义心理治疗对患者的外向性思维维度具有改善效果。三类干预方式均能有效缓解抑郁症症状，且认知行为疗法与存在主义心理治疗的疗效优于支持性咨询。