Trauma experience in individuals with idiopathic environmental intolerance and individuals with somatoform disorders

Experiences of persons with multiple chemical sensitivity with mental health providers

In this paper, we summarize the results of an online survey of persons in the United States with chemical intolerance/multiple chemical sensitivity who sought help from mental health providers, including counselors, psychologists, psychiatrists, and others. Respondents reported on their most recent contact with a provider, describing reasons for the contact, accommodations requested and received, and suggestions for how the experience could be more helpful. Overall, though clients were accommodated in small ways, some received no accommodation, and many felt that the providers needed to be more knowledgeable regarding chemical intolerance. Results are discussed in terms of the importance of providers becoming more aware of multiple chemical sensitivity and more willing to make their services accessible to these clients.

The feasibility of aromatherapy massage to reduce symptoms of Idiopathic Environmental Intolerance: a pilot study

OBJECTIVES

Idiopathic Environmental Intolerance (IEI) is an acquired disorder with multiple recurrent symptoms, which is associated with diverse environmental factors that are tolerated by the majority of people. IEI is an illness of uncertain aetiology, making it difficult to treat using conventional medicine. Therefore, there is a need for novel therapies to control the symptoms of IEI. The objective of this study was to evaluate the feasibility and impact of aromatherapy massage for individuals with IEI.

DESIGN

Non-blinded crossover trial.

SETTING

IEI patients who attended a clinic in Sapporo city were recruited, and sixteen patients were enrolled. Participants were clinically examined by an experienced medical doctor and met the criteria included in the working definition of IEI disorder.

INTERVENTIONS

During the active period, participants received four one-hour aromatherapy massage sessions every two weeks. During the control period, the participants did not receive any massages.

MAIN OUTCOME MEASUREMENTS

Scores on the IEI-scales trigger checklist, symptoms, life impact, and the State Anxiety Inventory were assessed before and after each period. Short-term mood enhancement was evaluated using the Profiles of Mood Status (POMS) before and after sessions.

RESULTS

Due to period effects, evaluation of the results had to be restricted to the first period, and the result showed no effect of intervention. All six sub-scales of the POMS improved after each session (mean score differences: 4.89-1.33, P<0.05).

CONCLUSIONS

Aromatherapy was well tolerated by subjects with IEI; however, aromatherapy, as applied in this study, did not suggest any specific effects on IEI condition.

Evidence for a specific link between the personality trait of absorption and idiopathic environmental intolerance

Absorption as a personality trait refers to the predisposition to get deeply immersed in sensory (e.g., smells, sounds, pictures) or mystical experiences, that is, to experience altered states of consciousness. Absorption is markedly related to constructs openness to experiences, hypnotic suggestibility, imagination, and dissociation. Although absorption was hypothesized to be a risk factor for medically unexplained symptoms (MUS), the construct has yet not been investigated in individually suffering from idiopathic environmental intolerance (IEI), formerly better known as multiple chemical sensitivity (MCS). IEI is a complex condition marked by MUS, which patients attribute to various chemical substances that are typically detectable by their odor (e.g., exhaust emissions, cigarette smoke). The current study investigated whether IEI was related to the personality trait of absorption. In a longitudinal study, 54 subjects with IEI were compared to 44 subjects with a somatoform disorder (SFD), but without IEI, and 54 subjects with neither SFD nor IEI (control group, CG). Self-report measures of somatic symptoms, severity of IEI, and level of absorption were collected both at a first examination and 32 mo later. On both assessments, subjects with IEI and individuals with SFD reported similar highly elevated levels of MUS, compared to CG. In contrast to SFD, IEI was specifically related to elevated absorption scores. IEI was specifically associated with a tendency to experience self-altering states of consciousness. Since absorption is related to both openness to unusual experiences and elevated imaginative involvement, absorption might contribute to IEI via two routes by (1) enhancing the susceptibility for IEI-specific convictions and (2) fostering classical conditioning processes of MUS via enhanced cognitive-imaginative representations of assumed IEI triggers.

Moderne Gesundheitssorgen und ihre Beziehung zu umweltbezogenen Beschwerden

Zusammenfassung. Theoretischer Hintergrund: Nach Petrie und Wessely (2002) bedeuten neue Technologien (z.B. Mobiltelefone und gentechnologisch veränderte Nahrungsmittel) neue Gesundheitssorgen und -beschwerden. Diese modernen Gesundheitssorgen können mittels Fragebogen standardisiert erfasst werden. Fragestellung: Es wurden die Faktorenstruktur, Reliabilität und Validität einer deutschen Übersetzung der Modern Health Worries (MHW) Scale sowie deren Beziehung zu einem funktionellen umweltbezogenen Syndrom, der Idiopathischen Umweltintoleranz (IUI), untersucht. Methode: 757 Studenten einer deutschen Universität füllten Fragebögen zur Erfassung von MHW, IUI, Krankheitsangst, Depressivität und multiplen körperlichen Beschwerden aus. Ergebnisse: Die vier Subskalen der MHW-Skala - Umweltgifte, Umweltverschmutzung, belastete Nahrungsmittel und elektrische Strahlung - konnten faktorenanalytisch bestätigt werden. Die interne Konsistenz (Cronbach’s α) der Subkalen erreichte Werte zwischen .77 und .89. MHW, negativer Affekt und Somatisierungsneigung trugen als unabhängige Prädiktoren jeweils signifikant zur Vorhersage des IUI-Beschwerdeniveaus bei. Schlussfolgerungen: Die deutsche Version der MHW-Skala kann als Messinstrument zur Verwendung für wissenschaftliche Zwecke empfohlen werden. Die Implikationen der Befunde für ein psychogenes Modell der IUI werden diskutiert.

Psychological predictors of short- and medium term outcome in individuals with idiopathic environmental intolerance (IEI) and individuals with somatoform disorders

Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity (MCS), is defined as a chronic polysymptomatic condition that cannot be explained by an organic disease. Previous studies suggest that IEI may be a variant of somatoform disorders (SFD), because both disorders overlap with respect to symptoms and psychological features of somatization. However, little is known about the short- and medium-term outcome of IEI and psychological outcome predictors. Two clinical groups (IEI and SFD) and a comparison group (CG) were followed through 32 mo to assess both the outcome, and the extent to which trait anxiety and somatic symptom attribution (assessed at first examination) predict outcome presented 12 and 32 mo later. Outcome measures were the number of self-reported IEI symptoms, IEI triggers, IEI-associated functional impairments, and the number of somatoform symptoms. In addition, the course of the 2 syndromes over the 32-mo follow-up period was investigated with standardized screening scales. The 3 diagnostic groups consisted of 46 subjects with IEI, 38 subjects with SFD but without IEI, and 46 subjects (CG) with neither IEI nor SFD. Syndrome stability was high over the 32-mo follow-up period, and at both follow-ups IEI and non-IEI subjects differed on all IEI outcome measures (symptoms, triggers, functional impairments). Both trait anxiety and somatic attribution (the tendency to attribute common somatic complaints to an illness) predicted outcome. In addition, somatic attribution was found to partially mediate the effect of trait anxiety on outcome in the IEI group. In conclusion, these results suggest that IEI is a chronic and disabling condition and that trait anxiety contributes to the maintenance of the disorder via somatic attributions.