Clin Psychopharmacol Neurosci.  2019 Mar;17(2):318-322. 10.9758/cpn.2019.17.2.318.

Alexithymia, Suicide Ideation and Homocysteine Levels in Drug Naïve Patients with Major Depression: A Study in the “Real World” Clinical Practice

  • 1National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, Teramo, Italy.
  • 2Department of Neurosciences and Imaging, University “G. D’Annunzio”, Chieti, Italy.
  • 3Department of Psychiatry, Federico II University, Naples, Italy.
  • 4Polyedra, Teramo, Italy.
  • 5School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
  • 6Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy.
  • 7Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “Madonna Del Soccorso”, National Health Service, San Benedetto del Tronto, Italy.
  • 8Department of Immunohematology and Transfusional Medicine, “G. Mazzini” Hospital, Teramo, Italy.
  • 9Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
  • 10Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy.


OBJECTIVE: This study was performed to elucidate relationships between alexithymia, suicide ideation and homocysteine levels in drug-naïve outpatients with major depressive disorder (MDD).
Sixty seven outpatients with MDD with melancholic features were evaluated by the means of the Hamilton Depression Rating Scale, the Toronto Alexithymia Scale (TAS–20), the Scale of Suicide Ideation, and homocysteine levels.
Alexithymic subjects showed higher scores on all scales and higher homocysteine levels. Regression analysis shown higher homocysteine levels and TAS-20’“Difficulty in Describing Feelings” dimension, in turn being associated with higher suicide ideation.
In conclusion, alexithymic MDD outpatients may characterize for homocysteine dysregulation that may be linked to suicide ideation, regardless depression’ severity. However, study limitations are discussed and must be considered.


Affective symptoms; Alexithymia; Depression; Suicidal ideation; Homocysteine
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