Alexithymia and treatment outcome: review on the role of alexithymia The authors examine the role played by alexithymia in the treatment of various medical and psychiatric disorders, and the post-treatment change of alexithymia. Most studies on patients with complicated grief, gastrointestinal somatization, major depression, substance abuse, and surgery have shown that those with higher alexithymia respond less favourably or more slowly to psychotherapeutic interventions, mostly when insight-oriented approaches are used. Only one published study showed a stable reduction over two years of alexithymia levels in patients with coronary heart disease. Clinicians who treat alexithymic patients should expect therefore fewer and slower treatment progress and implement substantial modifications to their psychotherapeutic approaches. [KEY WORDS: affect dysregulation, alexithymia, outcome, psychosomatics, psychotherapy]