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Alexithymia and cortisol awakening response in people with eating disorders

Published online by Cambridge University Press:  13 August 2021

G. Cascino ,
A.M. Monteleone ,
F. Marciello ,
V. Ruzzi ,
F. Pellegrino  and
P. Monteleone
G. Cascino*
Affiliation:
Department Of Medicine, Surgery And Dentistry, University of Salerno, Baronissi/Salerno, Italy
A.M. Monteleone
Affiliation:
Department Of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
F. Marciello
Affiliation:
Department Of Medicine, Surgery And Dentistry, University of Salerno, Baronissi/Salerno, Italy
V. Ruzzi
Affiliation:
Department Of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
F. Pellegrino
Affiliation:
Department Of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
P. Monteleone
Affiliation:
Department Of Medicine, Surgery And Dentistry, University of Salerno, Baronissi/Salerno, Italy
*
*Corresponding author.

Abstract

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Introduction

Alexithymia, that is the inability to recognize and describe one’s own emotions, is a transdiagnostic feature across eating disorders (EDs) and it has been associated to a prolonged stress exposure.

Objectives

Therefore, we evaluated whether alexithymia affects the hypothalamus-pituitary-adrenal (HPA) axis functioning in patients with anorexia nervosa (AN) or bulimia nervosa (BN).

Methods

Twenty-six women with AN and 26 with BN participated in the study. Alexithymia was evaluated by the Toronto Alexithymia Scale–20 and eating-related psychopathology was measured by the Eating Disorder Inventory-2. The activity of the HPA axis was assessed by the salivary cortisol awakening response (CAR). Group differences in saliva CAR were tested by repeated measures 3-way ANOVA with diagnosis and alexithymia as between-subject factors.

Results

The prevalence of alexithymia did not differ significantly between the two diagnostic groups (c2=1.24, p=0.26). Alexithymia was associated with more severe eating-related psychopathology in AN women but not in BN women. A significant reduction in the magnitude of CAR occurred in alexithymic patients with BN compared to non-alexithymic patients with BN (t = 3.39, p = 0.008), but not in alexithymic women with AN (t = 0.67, p = 0.54).

Conclusions

These results confirm the presence of a more severe eating-related psychopathology in alexithymic individuals with AN and show, for the first time, an association between alexithymia and a dampened basal activity of the HPA axis in BN.

Disclosure

No significant relationships.

Keywords

eating disordersalexithymiacortisolstress
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S114
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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