Alexithymia and somatisation in patients with remitted major depression and their impact on social functioning.

Dursun Hakan Delibas ,Asusinem Akyalcin Kirdok ,Almıla Erol

doi:10.4102/sajpsychiatry.v22i1.886

Abstract

ObjectivesThe aim of the present study is to investigate the level of social functioning, alexithymia and somatisation in patients with major depressive disorder who achieved full remission and to examine the impact of alexithymia and somatisation on social functioning in patients with major depression who are in full remission.MethodsA total of 117 outpatients with major depression and full remission and 42 healthy controls were included in the study. The participants were administrated Affect Underpinned by Severity and Social Impairment Questionnaire (AUSSI) to evaluate social functioning and depressive symptoms, Toronto Alexithymia Scale (TAS) to evaluate alexithymia and Somatosensory Amplification Scale (SSAS) to evaluate somatisation. Forty-one patients who scored higher or equal to the cut-off score of 5 on the social impairment subscale of AUSSI were classified as having impaired social functioning, whereas 76 patients who scored less than 5 were classified as having unimpaired social functioning.ResultsThere were no significant differences between the groups for AUSSI mood symptoms subscale score. Patients with impaired social functioning scored higher than controls on TAS score. Patients with both impaired and unimpaired social functioning scored higher than controls on SSAS scores. The only significant predictor of social impairment in patients with major depression who were in full remission was AUSSI mood symptoms subscale score.ConclusionPatients with major depression may still have social impairment after remission. Depressive symptoms are the most important predictors of social functioning in patients with remitted depression. Maximum precautions should be taken to treat depression without leaving any residual symptoms.

Highlights

Impairments in social functioning are common in major depressive disorder.[1]
There is an association between decreases in clinical symptoms and improvements in social functioning during acute treatment of depression, social functioning often does not return to baseline, and long-term impairments in social functioning may persist even in patients whose depression is in clinical remission.[2]
The aim of the present study is to investigate the level of social functioning, alexithymia and somatisation in patients with major depressive disorder who achieved full remission and to examine the impact of alexithymia and somatisation on social functioning in patients with major depression who are in full remission

Summary

Introduction

Impairments in social functioning are common in major depressive disorder.[1]. there is an association between decreases in clinical symptoms and improvements in social functioning during acute treatment of depression, social functioning often does not return to baseline, and long-term impairments in social functioning may persist even in patients whose depression is in clinical remission.[2]. Alexithymia is marked by difficulties in verbally describing affect and in differentiating mental states from bodily sensations. It was in the context of psychosomatic research that the alexithymia concept was first introduced, but its use extends beyond the field of psychosomatics now. Alexithymia is associated with higher somatic symptom reporting, and it may be associated with somatisation by way of focusing on or amplifying the somatic sensations associated with emotional arousal or by misinterpreting these as symptoms of disease.[3] Besides, somatisation has been shown to be associated with both alexithymia and depressive disorders.[4]

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