Mentalizing self and others: A controlled study investigating the relationship between alexithymia and theory of mind in major depressive disorder

BACKGROUND: Theory of mind (ToM) and alexithymia have been reported to relate with depression in recent studies. However, data regarding the role of alexithymia and ToM in depression remain uncertain. AIM: The aim of the current study was to determine the levels of alexithymia and ToM abilities as well as their relationship with each other and clinical features in major depressive disorder (MDD). MATERIALS AND METHODS: Patients diagnosed with MDD and healthy controls were undergone sociodemographic data, Beck Depression Inventory, Beck Anxiety Inventory, Toronto Alexithymia Scale (TAS-20), and reading the mind in the eyes test (RMET) to determine the depression, anxiety, alexithymia, and ToM abilities. RESULTS: Depression, anxiety, and alexithymia levels were higher, while ToM abilities were found to be decreased in MDD patients relative to controls. A positive correlation was observed between depression levels and alexithymia levels in terms of difficulty in identifying feelings subscale and total scores of TAS-20 (P = 0.006, P = 0.036, respectively), while a positive correlation was also observed between anxiety levels and alexithymia levels in terms of difficulty in describing feelings subscale scores of TAS-20 (P = 0.02) in depressed group. No correlation was found between depression, anxiety levels, and RMET accuracy scores. CONCLUSION: Our results suggest alexithymia and impaired ToM abilities might be prominent but prone to be distinct clinical constructs in MDD patients.