Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau (Barcelona), 1Servei de Psiquiatria, 2Servei de Pneumologia i Al.lergia Respiratòria del Hospital Clínic (Barcelona), 3Hospital de Mataró (Barcelona), and 4Hospital Cristal-Piñor

2 ABSTRACT. Alexithymia is a psychological trait characterised by difficulty in perceiving and expressing emotions and body sensations. Failure to perceive dyspnea could lead alexithymic asthmatics to underestimate the severity of an asthma exacerbation, and thereby increase the risk of developing a fatal or near-fatal asthma (NFA) attack. Our objective was to determine the prevalence of alexithymia in NFA patients and to analyse their clinical characteristics. Alexithymia was assessed by the Toronto Alexithymia Scale (TAS-26) in this multicentre, prospective, observational study. From 33 Spanish hospitals, we enrolled 179 NFA patients and 40 non-NFA patients as control group. There was a higher proportion of alexithymia in the NFA group than in th