A Study of the Characteristics of Alexithymia and Emotion Regulation in Patients with Depression

BACKGROUND Even though patients with depression often show significant alexithymia, the underlying mechanism of their alexithymia remains unclear. Furthermore, few experimental studies have explored their ability to regulate emotions. OBJECTIVE To explore the characteristics of alexithymia in patients with depression, and the relationship of depressive symptoms, alexithymia and emotion regulation. METHODS A total of 36 patients with depression and 31 healthy controls were enrolled. HAMD-24 and HAMA were used to evaluate depressive and anxious symptoms. Toronto Alexithymia Scale (TAS) was employed to assess alexithymia. A computer experiment was used to evaluate emotion regulation. RESULTS 66.67% of the patients with depression were considered as having alexithymia, but the rate in the control group was only 3.23%. The rates showed a significant difference (χ2=28.661, p<0.001). The score of TAS was higher in patients with depression than healthy controls (t=7.378, p<0.001). In a computerized emotional regulation experiment, under watch-neutral conditions, the emotion experience ratings of patients with depression were higher than those of controls (t=2.080, p=0.043); while under watch-negative, negative-reappraisal and negative-suppression conditions, the ratings of patients with depression showed no difference from those of the controls. The scores of TAS were correlated with the HAMD-24 scores and the HAMA scores significantly in patients with depression. However, the ratings on the emotional regulation experiment had no correlation with the HAMD-24 scores, the HAMA scores or the TAS scores. CONCLUSION The incidence of alexithymia is higher in patients with depression than the general population. The depressive symptoms may have interplay with alexithymia in patients with depression. Emotion regulation ability may be an independent trait and have nothing to do with the depressive state.