Abstract: Objective To investigate the effects of alexithymia and social support on anhedonia and depressive symptoms in the elderly patients with late-life depression (LLD). Methods A total of 216 elderly LLD patients aged ≥60 years who visited Psychosomatic Medicine Department of Zhongda Hospital, Southeast University, from 2020 to 2023 were assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17), the Snaith-Hamilton Pleasure Scale (SHAPS), the Toronto Alexithymia Scale (TAS), and the Social Support Rating Scale (SSRS).The relationships of the variables were explored by Pearson correlation analysis. The structural equation model (SEM) containing alexithymia, social support, anhedonia and depressive symptoms was constructed and analyzed by path analysis. Results The score of TAS was positively correlated with the scores of HAMD-17(r=0.294, P<0.001) and SHAPS (r=0.455, P<0.001), and negatively correlated with the score of SSRS (r=-0.210, P=0.002). The score of SSRS was negatively correlated with the scores of HAMD-17 (r=-0.299, P<0.001) and SHAPS (r=-0.230, P=0.001). The path analysis showed that the more severe alexithymia,the more severe depressive symptoms and anhedonia, while lower level of social support was associated with more severe alexithymia, depressive symptoms, and anhedonia. The final model showed good fit (χ²=0.211, df=1, χ²/df=0.211, RMSEA<0.001, CFI=1.000, GFI=1.000). Conclusions Enhancing social support can mitigate alexithymia and depressive symptoms, thereby improving the overall psychological health of LLD patients.

Key words: late-life depression, alexithymia, social support, depressive symptom, anhemonia, structural equation model