Interactional behaviour as a marker for screening patients with environment-related complaints.
BACKGROUND
Adequate assessment of symptoms of patients suffering from environmental illnesses requires appropriate procedures such as psychological and psychiatric diagnostics, medical screening and a thorough analysis of noxious environmental factors. The Basel pilot research project established a multi-methodological assessment procedure that meets these criteria. However, an exhaustive three-fold analysis is very costly in terms of both equipment and personnel, and hence the need for a heuristic approach and pre-screening persists.


METHODS
The three-fold diagnostic approach was preceded by a structured psychodynamic interview; the findings were used to construct a new profile of the patient's interactional behaviour (IB) in conjunction with the interviewer's countertransference. The extent to which this new profile could predict the results of the multi-method assessment was then assessed.


RESULTS
A low level of IB on the part of the patient significantly predicted the degree of stress and the extent of the psychiatric diagnosis, including personality disorders. A negative IB was associated with negative personality traits. Furthermore, a high level of IB implied more medical, but not more environmental, findings which could plausibly be related to the patient's complaints.


CONCLUSIONS
Assessment of patients' IB in conjunction with one's own countertransference is very helpful as a preliminary heuristic approach and may lead to consequences for treatment and therapy. Therefore, the training provided for experts who deal with patients suffering from environment-related complaints should place more specific emphasis on assessing patients' behaviour and on incorporating information gathered from countertransference. Nevertheless, an interdisciplinary assessment including medical, psychological/psychiatric, and environmental expertise remains mandatory for adequate and satisfactory diagnosis of patients with environment-related complaints.
Brand
Serge
S
Department of Psychotherapy and Psychohygienics, Psychiatric University Clinics Basel, Socinstr. 55a, 4051 Basel, Switzerland. serge.brand@upkbs.ch
Heller
Pia
P
Bircher
Andreas
A
Braun-Fahrländer
Charlotte
C
Huss
Anke
A
Niederer
Markus
M
Schwarzenbach
Simone
S
Waeber
Roger
R
Wegmann
Lukas
L
Küchenhoff
Joachim
J
D001519:Behavior; D003379:Countertransference; D018876:Environmental Illness / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010551:Personality; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires