title: Patients with environment-related disorders: comprehensive results of interdisciplinary diagnostics.
abstract: 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.
authors.affiliation: Department of Psychohygiene and Psychotherapy, Psychiatric University Clinics Basel, Socinstr. 55a, 4051 Basel, Switzerland.
authors.forename: Serge
authors.initials: S
authors.lastname: Brand
authors.forename: Pia
authors.initials: P
authors.lastname: Heller
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: Charlotte
authors.initials: C
authors.lastname: Braun-Fahrleander
authors.forename: Anke
authors.initials: A
authors.lastname: Huss
authors.forename: Markus
authors.initials: M
authors.lastname: Niederer
authors.forename: Simone
authors.initials: S
authors.lastname: Schwarzenbach
authors.forename: Roger
authors.initials: R
authors.lastname: Waeber
authors.forename: Lukas
authors.initials: L
authors.lastname: Wegmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Kuechenhoff
mesh_terms: 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