Patients with environment-related disorders: comprehensive results of interdisciplinary diagnostics.
BACKGROUND
Researchers dealing with environmental illnesses face complex diagnostic and methodological difficulties. Poor objective findings contrast with high subjective suffering and a firm belief that environmental exposure is the only source of complaints. The Basel pilot research project established a multi-modal assessment procedure and assessed complaints attributed to the environment. Medical, psychological and environmental findings were evaluated as to their pathogenic validity. Furthermore, patients were pooled into distinguishable subgroups in order to formulate more appropriate therapy strategies.


METHODS
Sixty-three patients took part in the threefold diagnostic approach (medical examination, psychiatric exploration, environmental analysis) of a mixed qualitative/quantitative study. Interdisciplinary case conferences allowed a consensus rating of the aetiological relevance of the findings to be reached. The discrepancy between self-rating and experts' judgement was exploited for subgroup formation.


RESULTS
About 50% of the patients' symptoms could be attributed to psychiatric causes. Based on self-rating and experts' judgement, four subgroups were distinguished with differing medical, psychiatric and environmental aetiologies, personality traits and interactional competencies.


CONCLUSIONS
Patients with environment-related disorders form a heterogeneous group. An interdisciplinary assessment and a comparison between self- and experts' judgements enable a more differentiated psychotherapeutic procedure and may enhance future treatment success.
Brand
Serge
S
Department of Psychohygiene and Psychotherapy, Psychiatric University Clinics Basel, Socinstr. 55a, 4051 Basel, Switzerland.
Heller
Pia
P
Bircher
Andreas J
AJ
Braun-Fahrleander
Charlotte
C
Huss
Anke
A
Niederer
Markus
M
Schwarzenbach
Simone
S
Waeber
Roger
R
Wegmann
Lukas
L
Kuechenhoff
Joachim
J
D000328:Adult; D000368:Aged; D016902:Air Pollution, Indoor / Q000009:adverse effects; D000818:Animals; D004781:Environmental Exposure; D018876:Environmental Illness / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012647:Self-Assessment; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology; D013315:Stress, Psychological