Clinical Differences Between Inpatients With and Without Alexithymia in Substance Use Disorder Treatment

This study investigates the clinical evolution of Belgian individuals following an inpatient treatment for substance use disorder (SUD), based on the presence or absence of alexithymia, as defined by difficulties in emotional identification and expression.

The objective of this study was to examine differences in clinical evolution during inpatient SUD treatment between individuals with high versus low levels of alexithymia. Among 119 inpatients, 92 were classified into two groups based on TAS-20 scores: a high-alexithymia group (n₁ = 51, 42.86%, TAS-20 > 60) and a low-alexithymia group (n₂ = 41, 34.45%, TAS-20 < 52). Clinical assessments were conducted at baseline, during the first week of hospitalization, and then at 2 weeks (n₁ = 35, n₂ = 29), and after 4 weeks of treatment (n₁ = 24, n₂ = 14).

At baseline, high alexithymia scores were associated with higher anxiety, emotional reactivity, and depressive symptoms. However, differences in addiction-related indicators, such as craving and self-efficacy, were less pronounced. All patients showed improvements in clinical symptoms during treatment, particularly in perceived stress and ruminations, but those with high alexithymia retained higher symptom severity. While both groups reported similar levels of craving, patients with alexithymia appeared to struggle more with emotional regulation.

These findings suggest that alexithymia may negatively impact emotional regulation during SUD treatment and potentially affect long-term recovery. The results highlight the need for increased interventions that enhance emotional processing in individuals with alexithymia. Limitations include the small sample size and reliance on self-report measures, which may affect generalizability. Overall, this research enhances understanding of alexithymia's contribution to SUD treatment and supports the necessity for tailored therapeutic approaches, warranting further investigation into long-term effects and specific interventions for alexithymic traits.