Background: The clinical validity of the newly developed 20-item Toronto Alexithymia Scale (TAS-20) with regard to the concept of somatization remains to be further established. This study attempts to determine the relationship between alexithymia and measures of psychopathology and illness severity in patients with somatoform disorders as compared to patients with chronic medical illness. Methods: Forty inpatients with a DSM-III-R somatoform disorder and 29 inpatients with a chronic medical illness completed the German version of the TAS-20, SCL-90-R, Whiteley Index, and a global rating of the severity of current psychosocial impairment. Results: Patients with a somatoform disorder scored significantly higher on the TAS-20 than the medically ill. As a result of stepwise multiple regression analysis, the SCL-90-R somatization scale emerged as a significant predictor of alexithymia in the somatizing patients, while the SCL-90-R depression scale and the severity of psychosocial impairment significantly predicted alexithymia in the medically ill. Conclusions: The results underline the clinical validity of the TAS-20 (German version) as well as the alexithymia construct.

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