Alexithymia is described as both a primary personality trait and a secondary state reaction to medical illness. To empirically study secondary alexithymia, a series of medically ill patients seen in psychiatric consultation were compared with a healthy control population. Measured by the Toronto Alexithymia Scale (TAS), the medically ill were more alexithymic than the healthy population. Alexithymia was best predicted by both depressed mood and lowered quality of life, rather than by the categorical ranking of the severity of the medical illness. Alexithymia did appear to be separate from self-reported mood. These data support the concept of secondary alexithymia.