title: An interdisciplinary therapeutic approach for dealing with patients attributing chronic fatigue and functional memory disorders to environmental poisoning--a pilot study.
abstract: Nonspecific symptoms and a general feeling of ill health that is difficult to objectify are the commonest health problems with which patients present to an Environmental Medicine Outpatient Department (OPD). Of this group, a great proportion meets the classification criteria for Chronic Fatigue Syndrome (CFS) or Functional Memory Disorders in association with Idiopathic Chronic Fatigue (FMD-ICF). This is a longitudinal study of the OPD of Environmental Medicine, Freiburg University Hospital, Germany, to determine the feasibility and impact of an interdisciplinary therapeutic approach (self-help program, acupuncture, psychosomatic support by group interventions) in 8 patients with CFS, FMD-ICF, or CFS in association with self-reported Multiple Chemical Sensitivities (sr-MCS). The intervention took into consideration the patients' need for treatment of physical aspects of their disease. This is an important step to motivate patients into required psychosomatic support. Although none of the patients was willing to accept psychosomatic support or psychotherapy at study outset, acceptance of psychosomatic group interventions was high during the study course. Additionally five patients started with personal counseling at the Psychosomatic Clinic, and, without feeling stigmatized, 4 patients started with specific psychotherapy. The patients' quality of life showed no increase after four months, but, as shown by the Sum-Score of SF-36, it had improved significantly at the end of the study, which covered eight months' treatment (p = 0.015). Two follow-up investigations showed that this improvement probably persisted in part (mainly in the dimensions mental health, social function, physical role function, and vitality). In conclusion our interdisciplinary therapeutic approach indicates successful treatment of patients attributing CFS, CFS/sr-MCS, and FMD-ICF to environmental poisoning. We now plan to conduct a randomized controlled trial in the future.
authors.affiliation: Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Hugstetter Strasse 55, D-79106 Freiburg, Germany. mlac@iuk3.ukl.uni-freiburg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Lacour
authors.forename: Thomas
authors.initials: T
authors.lastname: Zunder
authors.forename: Markus
authors.initials: M
authors.lastname: Dettenkofer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Schönbeck
authors.forename: Rainer
authors.initials: R
authors.lastname: Lüdtke
authors.forename: Carl
authors.initials: C
authors.lastname: Scheidt
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D003131:Combined Modality Therapy; D018876:Environmental Illness / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D015673:Fatigue Syndrome, Chronic / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D010348:Patient Care Team; D010865:Pilot Projects; D011602:Psychophysiologic Disorders / Q000175:diagnosis*; D011613:Psychotherapy; D011615:Psychotherapy, Group; D012657:Self-Help Groups; D012944:Social Support