Successful management of patients with "multiple chemical sensitivities" on an inpatient psychiatric unit.
BACKGROUND
Much controversy exists over the diagnosis, etiology, and treatment of "multiple chemical sensitivities" also known as "environmental illness." The experience of multiple nonspecific reactions to numerous environmental agents leads to these diagnoses. Due to skepticism surrounding the validity of these patients' complaints, they are often referred for psychiatric evaluations, but successful management on a psychiatric inpatient unit can be complicated because of their unique presentations.


METHODS
The approach taken by a university psychiatric inpatient unit to the evaluations of three such patients is presented along with a literature review of etiologic theories and treatment recommendations.


RESULTS
Each of the three patients presented with severe disability from their "sensitivities," but each improved significantly over the course of a 17-day hospitalization.


CONCLUSIONS
These patients benefited greatly from a serious, nonjudgmental, comprehensive approach to the evaluation of their multiple complaints. Despite the absence of any positive organic findings, each felt that her experiences had been validated, and each subsequently improved. When evaluating similar patients, clinicians should be aware of useful, effective management strategies and should avoid overt skepticism and confrontation.
Haller
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Department of Psychiatry, University of California, San Francisco 94143.
D000328:Adult; D001291:Attitude of Health Personnel; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006967:Hypersensitivity / Q000523:psychology / Q000628:therapy*; D011567:Psychiatric Department, Hospital; D011613:Psychotherapy