ALEXITHYMIA RATINGS IN BULIMIA-NERVOSA - CLINICAL CORRELATES

Previous reports indicate that some patients with eating disorders hav e alexithymic characteristics, including affect deficit states and pau city of imagination, This study evaluated whether nonhospitalized pati ents with bulimia nervosa had elevated ratings of alexithymia in compa rison to age-matched controls, and whether severity of bulimic symptom s was correlated with elevations in alexithymia ratings. Because alexi thymia may be secondary to concurrent depression, this study was limit ed to patients with bulimia nervosa who were free of major depression. The authors compared alexithymia ratings for nonhospitalized normal w eight women meeting DSM-III-R criteria for bulimia nervosa (N = 20) to healthy female volunteers (N = 20), utilizing the Toronto Alexithymia Scale (TAS) as the primary assessment instrument. Subjects also compl eted standardized rating scales for bulimic symptoms, depression, and anxiety. Alexithymia rating scale scores were significantly higher for patients with bulimia nervosa than for controls. In comparison to con trols, patients had significant elevations on TAS factors reflecting a ffect deficit states, but normal scores for factors reflecting imagina tion and abstract thinking. Frequency of binge eating or purging behav iors was not correlated with alexithymia ratings.These data indicate t hat some patients with bulimia nervosa have alexithymic characteristic s. Affect dysregulation was more prominent than limitation in fantasy or metaphorical thought. Additional studies are needed to assess wheth er presence of alexithymic characteristics may be predictive of respon se to treatment in patients with bulimia nervosa.