ObjectiveTo analyze the correlation between the facial emotion deficits and alexithymia or flat affect in patients with schizophrenia. MethodsEighty-two schizophrenic patients and eighty-eight healthy subjects were tested with the Chinese Facial Emotion Test (CFET)and Toronto Alexithymia Scale(TAS-26),and rated on the flatten affective subscale of the SANS. ResultsFor patients with schizophrenia, the total correct score and scores of recognition for each of six basic emotions were significantly less(P<0.01), and the scores of factor I, II, or IV on TAS-26 were significantly more (P<0.01)than that of controls. There was a significantly negative correlation between scores of CFET and the scores of factor I, II, or IV on TAS-26, in which 27 of 35(71.4%) correlation coefficients reach statistic significance. and also a significantly negative correlation between some scores of CFET and flatten affective subscale of the SANS, in which 9 of 49 (18.4%) correlation coefficients reach statistic significance. There was no significant correlation between scores of TAS-26 and subscales of symptom, apart from subscale of eye attach. ConclusionThe impairment of facial emotion recognition as well as alexithymia indicated a special trait in schizophrenics. both of two symptoms may be involved in a common neural substrates, while the dissociation between alexithymia and flatten affection may suggested a different pathological emotion processing.