Abstract
OBJECTIVE: Idiopathic environmental intolerance (IEI), also known
as multiple chemical sensitivity, is a chronic, polysymptomatic condition
that cannot be explained by an organic disease. Physical and psychological
complaints are believed to be sustained by low levels of chemically
unrelated substances in the environment. At present, it is unclear
whether IEI is an environmental illness or a variant of somatoform
disorders (SFD). This study examined whether IEI can be distinguished
from SFD with respect to self-reported symptoms, trait anxiety, body-related
cognitions, and symptom attributions. METHODS: We compared 54 subjects
with IEI, 54 subjects with SFD but without IEI, and 44 subjects with
neither IEI nor SFD on symptom scales, psychological questionnaires,
and structured interviews for IEI, depression, anxiety, and SFD.
RESULTS: More than half of the IEI subjects met Diagnostic and Statistical
Manual of Mental Disorders, fourth edition criteria of SFD. This
group shared both symptoms and psychological features of somatization
with the SFD group. IEI subjects who did not fulfill criteria for
a specific SFD were less impaired by their chemical sensitivity but
differed nevertheless from nonsomatoform controls by significantly
higher symptom scores, higher trait anxiety, a focus on autonomic
sensations, and more pronounced somatic symptom attributions. These
psychological features were significantly associated with the burden
of somatic symptoms in both SFD and IEI. Furthermore, self-reported
allergy but not total immunoglobulin E correlated with symptom burden
in the total sample. CONCLUSIONS: The similarity of IEI and SFD regarding
symptoms and psychological features of somatization support the hypothesis
that IEI is a variant of SFD.
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