There is a dearth of literature on the effect of alexithymia on somatizing depression. Yet, the symptom manifestation of depression among people with alexithymia has not been well-investigated. The objective of this study was to examine symptom presentation in adolescents having high (HDA) or low (LDA) degrees of alexithymia.

A total of 590 adolescents aged 11–18 years participated in this school-based study. of 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15), 136 participants were selected and identified as either having HDA (n = 100) or LDA (n = 36). Confirmatory factor analyses (CFAs) tested the fit of a correlated two-factor structure (somatic and affective symptoms of CES-D) to the data. HDA adolescents were compared to those with LDA on somatic and affective symptoms of depression, negative affect and somatization symptoms.

Results of CFAs confirmed the two-factor model in HDA (CFI = 0.863) and LDA (CFI = 0.874) adolescents. HDA adolescents reported more somatic symptoms of depression (t = −2.97, p = 0.004) and negative affect (t = −3.53, p = 0.001) compared with LDA adolescents. No significant difference was observed between HDA and LDA adolescents on affective symptoms of depression and somatization symptoms (p > 0.05).

Our findings underscore that (1) HDA adolescents reported affective symptoms of depression in a similar manner to LDA adolescents, and (2) though the tendency toward reporting somatic symptom of depression is evident, HDA adolescents did not report significantly more somatization symptoms. These findings refute the notion that patients with alexithymia articulate their emotional and psychological distress primarily through physical symptomatology.