Alexithymia and Emotion Recognition Over the Treatment Course in Adolescents and Emerging Adults With Anorexia Nervosa.

Objective: To investigate longitudinal changes in alexithymia and emotion recognition among adolescents and emerging adults with anorexia nervosa (AN) and whether these domains can independently predict the long-term eating disorder (ED) outcome.

Method: Ninety-one female patients with AN (mean age: 16.2; 87.6% restrictive type) were included. Forty-five patients received the Maudsley Model Anorexia Nervosa Treatment (MANTRa) and 46 patients received psychotherapeutic treatment-as-usual (TAU). Alexithymia and facial emotion recognition were assessed at baseline and after 1 year. ED pathology was assessed at four time points (until 18-months follow-up).

Results: Alexithymia significantly improved until follow-up when controlled for weight change, with no significant difference between the MANTRa and TAU groups. There was no change in emotion recognition accuracy while we observed significant reductions in emotion recognition response times. Neither baseline alexithymia nor emotion recognition accuracy significantly predicted ED outcome when adjusted for illness severity psychiatric comorbidity. The effects of improvements in alexithymia on improvements in ED pathology were partly mediated by change in depression.

Conclusions: We recommend to routinely assess alexithymia in young people with AN. Therapeutic interventions helping patients to identify, differentiate, and describe their emotions should be intensified. Psychoeducational elements, expressive writing and group intervention components may be supportive.