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Molot J, Sears M, Anisman H. Multiple Chemical Sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev 2023; 151:105227. [PMID: 37172924 DOI: 10.1016/j.neubiorev.2023.105227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Margaret Sears
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Hymie Anisman
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
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Szemerszky R, Dömötör Z, Witthöft M, Köteles F. Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation. J Psychosom Res 2021; 146:110501. [PMID: 33930739 DOI: 10.1016/j.jpsychores.2021.110501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Paranoid ideation is assumed to characterize worries about possible harmful effects of modern technologies (MHWs) and idiopathic environmental intolerances (IEIs), such as IEI attributed to electromagnetic fields (IEI-EMF). Empirical evidence on these associations is scarce. METHODS In a cross-sectional on-line survey, participants of a community sample (n = 700; mean age: 28.4 ± 12.0; 434 females) completed the Somatosensory Amplification Scale, the Modern Health Worries Scale, and the Paranoid Ideation scale of the Symptom Checklist 90 Revised. They were considered IEI-EMF if (1) they categorized themselves so, (2) they had experienced symptoms that they attributed to the exposure to electromagnetic fields, and (3) the condition impacted their everyday functioning. RESULTS Paranoid ideation was significantly positively associated with MHWs (standardized β = 0.150, p < .001) even after controlling for socio-demographic variables and somatosensory amplification tendency, an indicator of somatic symptom distress. Also, paranoid ideation explained significant variability in IEI-EMF (OR = 1.090, 95% CI: 1.006-1.180, p = .035) even after statistically controlling for socio-demographic variables and somatosensory amplification. CONCLUSIONS Paranoid ideation was found to be associated with MHWs and IEI-EMF. This association appears independent of general somatic symptom distress in both cases. This might partly explain the temporal stability of these constructs.
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Affiliation(s)
- Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
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Nordin S. Mechanisms underlying nontoxic indoor air health problems: A review. Int J Hyg Environ Health 2020; 226:113489. [DOI: 10.1016/j.ijheh.2020.113489] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
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Selinheimo S, Vuokko A, Hublin C, Järnefelt H, Karvala K, Sainio M, Suojalehto H, Paunio T. Psychosocial treatments for employees with non-specific and persistent physical symptoms associated with indoor air: A randomised controlled trial with a one-year follow-up. J Psychosom Res 2020; 131:109962. [PMID: 32078837 DOI: 10.1016/j.jpsychores.2020.109962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Persistent physical symptoms (PPS) associated with indoor air without an adequate pathophysiological- or environmental-related explanation may lead to work disability and decreased health-related quality of life (HRQoL). We attempted to assess the effect of cognitive behavioural therapy (CBT) for PPS and also psychoeducation (PE) on these symptoms involving disability. METHOD The intention-to-treat (ITT) sample included 52 employees recruited from an occupational healthcare service randomised as either controls undergoing treatment as usual (TAU) or TAU enhanced with CBT or PE. The primary outcome was HRQoL measuring the severity of symptoms and restrictions in everyday life caused by them. Secondary outcomes included depressive, anxiety and insomnia symptoms, and intolerance to environmental factors, assessed at baseline and at 3-, 6- and 12-month follow-ups. RESULTS At the 12-month follow-up assessment point, no statistically significant differences between treatments emerged following adjustment for gender, age, and HRQoL before the waiting period in the ITT analysis [F(2,46)=2.89, p=.07]. The secondary analysis revealed a significant improvement in HRQoL in the combined intervention group as compared with controls [F(1,47)=5.06, p=.03, g=0.41]. In total, 15% of participants dropped out during follow-up. CONCLUSIONS The results suggest that CBT for PPS or PE might not have a robust effect on HRQoL in PPS associated with indoor air, but the study did not achieve the planned power. Despite difficulties during the recruitment process, the final dropout rates remained low, and participants positively evaluated CBT, suggesting that it represents an acceptable treatment to them. Trial status This study was registered at the ClinicalTrials.gov registry (NCT02069002).
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Affiliation(s)
- Sanna Selinheimo
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
| | - Aki Vuokko
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Christer Hublin
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Heli Järnefelt
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, Helsinki, Finland; Insurance Medicine and Rehabilitation Unit, Keva, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | | | - Tiina Paunio
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry and the SleepWell Research Program, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Chemical intolerance: involvement of brain function and networks after exposure to extrinsic stimuli perceived as hazardous. Environ Health Prev Med 2019; 24:61. [PMID: 31640568 PMCID: PMC6806489 DOI: 10.1186/s12199-019-0816-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023] Open
Abstract
Background Chemical intolerance (CI) is a chronic condition characterized by recurring and severe symptoms triggered by exposure to low levels of odorous or pungent substances. The etiology of CI has been a controversial subject for a long time. The aim of this review is to summarize findings on the neurological processing of sensory information during and after exposure to low levels of odorous or pungent substances in individuals with CI, focusing on the brain function and networks. Methods Scientific studies on CI published between 2000 and 2019 in academic peer-reviewed journals were systematically searched using medical and scientific literature databases. Only peer-reviewed articles reporting original research from experimental human studies directly associated with CI, and involving related neurological responses or brain imaging after exposure to odorous or pungent substances (i.e., in chemical provocation tests), were considered. Results Forty-seven studies were found to be eligible for a full-text review. Twenty-three studies met the selection criteria and were included in this review. Evidence indicated that differences between subjects with CI and healthy controls were observed by brain imaging during and after exposure to odorous or pungent substances. Differences in brain imaging were also observed between initial exposure and after exposure to these substances. Neurological processing of sensory information after exposure to extrinsic stimuli in the limbic system and related cortices were altered in subjects with CI. A previous documentable exposure event was likely to be involved in this alteration. Conclusions This review documents consistent evidence for the altered neurological processing of sensory information in individuals with CI. Further neurophysiological research exploring the processing of extrinsic stimuli and cognition of sensation through the limbic system and related cortices in CI, and the appearance of symptoms in individuals with CI, are required.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan. .,Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.,Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan
| | - Mari Tanigawa
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan.,Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, 184-8501, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, 635-0832, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, 259-1193, Japan
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Dömötör Z, Nordin S, Witthöft M, Köteles F. Modern health worries: A systematic review. J Psychosom Res 2019; 124:109781. [PMID: 31443819 DOI: 10.1016/j.jpsychores.2019.109781] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Modern health worries (MHWs) refer to people's concerns about possible harmful effects of modern technologies, and are widespread in the developed countries. The aim of the present work was to provide comprehensive, yet integrated understanding for MHWs and associated factors. METHODS Following the PRISMA guideline, a systematic review was conducted based on 48 empirical articles published between 2001 and 2018 (Prospero registration number: CRD42018103756). All empirical studies were included that (1) were published between 2001 and 2018 in peer-reviewed scientific journals in English, German, or Hungarian, (2) used the Modern Health Worries Scale or any of its sub-scales, and (3) assessed associations between MHWs and other constructs and/or compared criterion groups (i.e. purely psychometric studies were excluded). RESULTS The results from the review suggest that female gender, age, somatic symptom distress and idiopathic environmental intolerances, holistic thinking, and paranoid beliefs are positively associated with MHWs, whereas educational qualification and the five major dimensions of personality appear not to be. CONCLUSION Scientific inquiry on the MHWs phenomenon is still in its descriptive-explorative phase; more rigorously designed studies are needed. The presented theoretical framework integrates illness-related and holistic thinking-related aspects of MHWs as a starting point to guide further research in this area.
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Affiliation(s)
- Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
| | | | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
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Health-related quality among life of employees with persistent nonspecific indoor-air-associated health complaints. J Psychosom Res 2019; 122:112-120. [PMID: 30935665 DOI: 10.1016/j.jpsychores.2019.03.181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/24/2019] [Accepted: 03/24/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Nonspecific health complaints associated with indoor air are common in work environments. In some individuals, symptoms become persistent without an adequate explanation. The aim was to study factors that associate with the health-related quality of life (HRQoL) of employees with persistent, nonspecific indoor-air-related symptomatology. METHODS We present baseline results of a randomized controlled trial of interventions targeted on the HRQoL of the employees with indoor-air-associated nonspecific symptoms. The main participant-inclusion criterion was the presence of persistent indoor-air-related multiorgan symptoms with no known pathophysiological or environment-related explanation. As a comparison for participants´ HRQoL (n = 52) we used data from the general-population Health 2011 study (BRIF8901) including information on subjects matched to the participants´ working status and age and subjects with asthma, anxiety or depressive disorder, or other chronic conditions with work disability. RESULTS The participants showed greater and a clinically significant impairment of HRQoL [M = 0.83, SE = 0.013] than individuals from the general population [M = 0.95, SE = 0.001, p < .001, Hedges´ g = 2.33] and those with asthma [M = 0.93, SE = 0.005, p < .001, Hedges´ g = 1.46], anxiety and depressive disorder [M = 0.89, SE = 0.006, p < .001, Hedges´ g = 0.73], or a chronic condition with work disability [M = 0.91, SE = 0.003, p < .001, Hedges´ g = 1.11]. Prevalent symptoms of depression, anxiety, and insomnia and poor recovery from work were associated with a poor HRQoL. CONCLUSIONS Individuals with nonspecific indoor-air-associated symptoms have a poorer HRQoL than individuals in the general population with a globally burdensome disease. Psychological distress associated with a poor HRQoL should be considered in the making of decisions about the treatment of these patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02069002.
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Azuma K, Uchiyama I, Kunugita N. Factors affecting self-reported chemical intolerance: A five-year follow-up study in Japan. J Psychosom Res 2019; 118:1-8. [PMID: 30782347 DOI: 10.1016/j.jpsychores.2019.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Chemical intolerance (CI) has become a strong public health concern in industrialized countries. The Japanese Chemical Intolerance (JCI) study was conducted in January 2012 with a cohort of 7245 adults from population-based sampling as the baseline. The aim of the present study was to investigate the factors involved in the improvement and development of CI from the five-year follow-up study. METHODS From the 7245 cohort, 735 persons with CI (case) were identified, and 1750 controls without CI were randomly selected to match gender and age for case and control groups. Self-reported questionnaires were administered to the subjects of the two groups to obtain information on status of CI; medical history; medical, lifestyle, or physical interventions; changes in living situation or occupation; and psychosomatic states. RESULTS A total of 909 individuals responded during the follow-up period. After five years, improvement in CI was observed in 67.7% of the case group. Status of CI was reported in 6.7% of the control group. Multiple logistic regression analyses revealed that baseline atopic dermatitis and negative psychosomatic states including irritability, fatigue, anxiety, depressed mood, and somatic symptoms were significantly associated with development of CI in controls. Appropriate physical activity and maintaining a regular lifestyle including diet or sleep during the last three years of the follow-up period were significant factors for improvement of CI in the case group. CONCLUSIONS Ensuring appropriate physical activity and regular lifestyle rather than improving physical environment lead to improvement of CI. Stable psychosomatic state is essential for preventing CI.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan; Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto 606-8225, Japan; Department of Environmental Health, National Institute of Public Health, Wako 351-0197, Japan.
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto 606-8225, Japan.
| | - Naoki Kunugita
- Department of Environmental Health, National Institute of Public Health, Wako 351-0197, Japan.
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Comorbidity and Multimorbidity of Asthma and Allergy and Intolerance to Chemicals and Certain Buildings. J Occup Environ Med 2018; 59:80-84. [PMID: 28045802 DOI: 10.1097/jom.0000000000000930] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We tested the hypothesis of high comorbidity between asthma/allergy and chemical intolerance (CI) and between asthma/allergy and building intolerance (BI), and high multimorbidity between asthma/allergy, CI, and BI. METHODS Population-based questionnaire data were used from 530 participants with asthma/allergy (allergic asthma, nonallergic asthma, allergic rhinitis, and/or atopic dermatitis), 414 with self-reported and 112 with physician-diagnosed CI, and 165 with self-reported and 47 with physician-diagnosed BI. Separate reference groups were formed for each of the five case groups. RESULTS Adjusted odds ratios varied from 4.6 to 13.1 for comorbidity, and from 6.6 to 46.4 for multimorbidity. CONCLUSION The large comorbidity and multimorbidity between asthma/allergy, CI, and BI evokes the question as to whether there are similarities in underlying mechanisms between these conditions.
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Vuokko A, Karvala K, Lampi J, Keski-Nisula L, Pasanen M, Voutilainen R, Pekkanen J, Sainio M. Environmental Intolerance, Symptoms and Disability Among Fertile-Aged Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020293. [PMID: 29419757 PMCID: PMC5858362 DOI: 10.3390/ijerph15020293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/04/2018] [Accepted: 02/06/2018] [Indexed: 12/12/2022]
Abstract
The purpose was to study the prevalence of environmental intolerance (EI) and its different manifestations, including behavioral changes and disability. Fertile-aged women (n = 680) of the Kuopio Birth Cohort Study were asked about annoyance to 12 environmental factors, symptoms and behavioral changes. We asked how much the intolerance had disrupted their work, household responsibilities or social life. We chose intolerance attributed to chemicals, indoor molds, and electromagnetic fields to represent typical intolerance entities. Of the respondents, 46% reported annoyance to chemicals, molds, or electromagnetic fields. Thirty-three percent reported symptoms relating to at least one of these three EIs, 18% reported symptoms that included central nervous system symptoms, and 15% reported behavioral changes. Indicating disability, 8.4% reported their experience relating to any of the three EIs as at least “somewhat difficult”, 2.2% “very difficult” or “extremely difficult”, and 0.9% “extremely difficult”. Of the latter 2.2%, all attributed their intolerance to indoor molds, and two thirds also to chemicals. As the number of difficulties increased, the number of organ systems, behavioral changes and overlaps of the three EIs also grew. EI is a heterogeneous phenomenon and its prevalence depends on its definition. The manifestations of EI form a continuum, ranging from annoyance to severe disability.
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Affiliation(s)
- Aki Vuokko
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Jussi Lampi
- Environmental Health, National Institute for Health and Welfare, P.O. Box 95, 70701 Kuopio, Finland.
- Social and Health Services, 70701 Kuopio, Finland.
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynecology, Kuopio University Hospital, P.O. Box 100, 70029 KYS Kuopio, Finland.
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, P.O Box 1627, 70211 Kuopio, Finland.
| | - Markku Pasanen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.
| | - Raimo Voutilainen
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, P.O Box 1627, 70211 Kuopio, Finland.
- Department of Pediatrics, Kuopio University Hospital, P.O. Box 100, 70029 KYS Kuopio, Finland.
| | - Juha Pekkanen
- Environmental Health, National Institute for Health and Welfare, P.O. Box 95, 70701 Kuopio, Finland.
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
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The association between multiple chemical sensitivity and mental illness: Evidence from a nationally representative sample of Canadians. J Psychosom Res 2017; 99:40-44. [PMID: 28712429 DOI: 10.1016/j.jpsychores.2017.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/17/2017] [Accepted: 06/05/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The goal of the present study was to investigate the association between multiple chemical sensitivity (MCS) and major depressive disorder (MDD), generalized anxiety disorder (GAD), MDD and GAD comorbidity (MDD+GAD), severe distress, and positive mental wellbeing. METHODS This cross-sectional investigation was carried out using the 2012 Canadian Community Health Survey - Mental Health Component. The study population consisted of 21,977 individuals aged 20 and older, from Canada's ten provinces. Odds ratios were computed using multinomial logistic regression to calculate estimates of the association between MCS and mental illness. All analyses were weighted to take into account the complex survey design. RESULTS Individuals with MCS had 2.37 (1.55, 3.64) times greater odds of MDD, 3.09 (1.80, 5.30) times greater odds of MDD+GAD, and 2.60 (1.67, 4.07) times greater odds of severe distress. No association between MCS and GAD was observed. A sex difference was observed with males with MCS having lower odds of positive mental wellbeing, whereas no association was observed in females. CONCLUSIONS The present study findings supported an association between MCS and mental illness. The causal mechanism supporting this association remains unclear.
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Eberle S. An Underworld Journey: Learning to Cope with Electromagnetic Hypersensitivity. ECOPSYCHOLOGY 2017. [DOI: 10.1089/eco.2016.0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Scott Eberle
- Hospice of Petaluma, Petaluma, California
- School of Lost Borders, Big Pine, California
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Weiss EM, Singewald E, Baldus C, Hofer E, Marksteiner J, Nasrouei S, Ruepp B, Kapfhammer HP, Fitz W, Mai C, Bauer A, Papousek I, Holzer P. Differences in psychological and somatic symptom cluster score profiles between subjects with Idiopathic environmental intolerance, major depression and schizophrenia. Psychiatry Res 2017; 249:187-194. [PMID: 28113122 DOI: 10.1016/j.psychres.2016.12.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 11/29/2016] [Accepted: 12/28/2016] [Indexed: 11/24/2022]
Abstract
Idiopathic Environmental Intolerance (IEI) has been associated with psychogenic factors and an increased number of comorbid psychiatric disorders such as depression and anxiety disorder. The purpose of the current study was to examine a possible overlap of psychological and somatic symptoms between subjects with IEI and patients with major depression and schizophrenia as well as to specify characteristic differences. The different symptom clusters included symptoms of chemical intolerance, neurotoxicity and psychological distress as well as measurements of mental health such as anxiety, depression, somatoform symptoms, and schizophrenia-specific disturbances in cognitive domains. IEI patients reported higher overall levels in physical symptoms such as chemical intolerance, neurotoxicity and somatic symptoms not attributable to an organic cause. Schizophrenia patients showed higher overall levels in self-experienced disturbances in several schizophrenia-specific cognitive domains, whereas general psychological distress, anxiety and depression were rated highest by patients with major depression. Importantly, the groups markedly differed in the shapes of profiles of various symptom clusters. Our results provide evidence that IEI patients can be distinguished on the phenomenological level from patients with major depression or schizophrenia, and that distinct domains of psychological and somatic symptoms are particularly problematic in specific diagnostic groups.
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Affiliation(s)
- Elisabeth M Weiss
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria.
| | - Evelin Singewald
- Department of Psychiatry and Psychotherapy A, LKH Hall, Austria; Research Unit of Translational Neurogastroenterology, Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Universitätsplatz 4, A-8010 Graz, Austria
| | - Claudia Baldus
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | - Ellen Hofer
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | | | - Sarah Nasrouei
- Department of Psychiatry and Psychotherapy A, LKH Hall, Austria
| | - Beatrix Ruepp
- Department of Psychiatry and Psychotherapy A, LKH Hall, Austria
| | - Hans-Peter Kapfhammer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - Werner Fitz
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - Christoph Mai
- Umweltmedizin, Fachkliniken Nordfriesland, Bredstedt, Germany
| | - Anke Bauer
- Umweltmedizin, Fachkliniken Nordfriesland, Bredstedt, Germany
| | - Ilona Papousek
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | - Peter Holzer
- Research Unit of Translational Neurogastroenterology, Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Universitätsplatz 4, A-8010 Graz, Austria; BioTechMed-Graz, Krenngasse 37/1, 8010 Graz, Austria
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Facco E, Lucangeli D, Tressoldi P. On the Science of Consciousness: Epistemological Reflections and Clinical Implications. Explore (NY) 2017; 13:163-180. [PMID: 28359768 DOI: 10.1016/j.explore.2017.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Indexed: 12/18/2022]
Abstract
Consciousness has been one of the most important and tantalizing issues ever since the origin of philosophy and medicine. The concept of consciousness and the so-called "hard problem" (i.e., the mind-brain relationship) are highly complex topics that have yet to be elucidated, involving the realms of both science and philosophy with profound epistemological implications. In the lively debate on the foundations of the science of consciousness there are several potential biases of an essentially philosophical nature, such as those related to the paradigm and axioms adopted, and the ostensible logical contradiction between monism and dualism. Their origin dates back largely to Descartes' thinking and the birth of the new sciences as a compromise with the Inquisition, but they have been handed down through the Enlightenment and Positivism. A proper investigation of consciousness and the world of subjectivity demands a careful reflection on the paradigm of scientific medicine to identify possible flaws and overcome the limits of the mechanistic-reductionist approach.
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Affiliation(s)
- Enrico Facco
- Studium Patavinum, University of Padua, Italy; Institute Franco Granone-Italian Center of Clinical & Experimental Hypnosis (CIICS), Turin, Italy.
| | - Daniela Lucangeli
- Department of Developmental Psychology and Socialization, University of Padua, Italy; Human Potential Network Research Foundation, Padua, Italy
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Köteles F, Simor P, Czető M, Sárog N, Szemerszky R. Modern health worries - the dark side of spirituality? Scand J Psychol 2016; 57:313-20. [DOI: 10.1111/sjop.12297] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences; Eötvös Loránd University; Budapest Hungary
| | - Péter Simor
- Department of Cognitive Sciences; Budapest University of Technology and Economics; Hungary
- Nyírő Gyula Hospital National Institute of Psychiatry and Addictions; Hungary
| | | | - Noémi Sárog
- Institute of Psychology; Eötvös Loránd University; Hungary
| | - Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences; Eötvös Loránd University; Budapest Hungary
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Teufel M, Zipfel S. Somatoforme Körperbeschwerden und umweltbezogene Gesundheitsstörung. ALLERGOLOGIE 2016. [DOI: 10.1007/978-3-642-37203-2_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Azuma K, Uchiyama I, Katoh T, Ogata H, Arashidani K, Kunugita N. Prevalence and Characteristics of Chemical Intolerance: A Japanese Population-Based Study. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2015; 70:341-353. [PMID: 25137616 DOI: 10.1080/19338244.2014.926855] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Population-based cross-sectional study was performed to estimate the prevalence of chemical intolerance and to examine the characteristics of the sample. A Web-based survey was conducted that included 7,245 adults in Japan. The criteria for chemical intolerance proposed by Skovbjerg yielded a prevalence of 7.5% that was approximately consistent with that reported from a Danish population-based survey. Female gender, older age, and renovation in the house during the past 7 years were positively associated with chemical intolerance. Improvements in the condition were observed with daily ventilation habits. Medical history of atopic dermatitis, allergic rhinitis, food allergy, multiple chemical sensitivity, and depression were associated with chemical intolerance. Fatigue, depressed mood, and somatic symptoms were also positively correlated with chemical intolerance. Better elucidation of the causes, comorbidities, concomitants, and consequences of chemical intolerance has the potential to provide effective solutions for its prevention and treatment.
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Affiliation(s)
- Kenichi Azuma
- a Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine , Osaka , Japan
- b Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Iwao Uchiyama
- b Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Takahiko Katoh
- c Department of Public Health, Graduate School of Life Sciences, Kumamoto University, Kumamoto , Japan
| | - Hiromitsu Ogata
- d Center for Public Health Informatics, National Institute of Public Health , Saitama , Japan
| | | | - Naoki Kunugita
- f Department of Environmental Health, National Institute of Public Health , Saitama , Japan
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Azuma K, Uchiyama I, Takano H, Tanigawa M, Azuma M, Bamba I, Yoshikawa T. Changes in cerebral blood flow during olfactory stimulation in patients with multiple chemical sensitivity: a multi-channel near-infrared spectroscopic study. PLoS One 2013; 8:e80567. [PMID: 24278291 PMCID: PMC3836968 DOI: 10.1371/journal.pone.0080567] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is characterized by somatic distress upon exposure to odors. Patients with MCS process odors differently from controls. This odor-processing may be associated with activation in the prefrontal area connecting to the anterior cingulate cortex, which has been suggested as an area of odorant-related activation in MCS patients. In this study, activation was defined as a significant increase in regional cerebral blood flow (rCBF) because of odorant stimulation. Using the well-designed card-type olfactory test kit, changes in rCBF in the prefrontal cortex (PFC) were investigated after olfactory stimulation with several different odorants. Near-infrared spectroscopic (NIRS) imaging was performed in 12 MCS patients and 11 controls. The olfactory stimulation test was continuously repeated 10 times. The study also included subjective assessment of physical and psychological status and the perception of irritating and hedonic odors. Significant changes in rCBF were observed in the PFC of MCS patients on both the right and left sides, as distinct from the center of the PFC, compared with controls. MCS patients adequately distinguished the non-odorant in 10 odor repetitions during the early stage of the olfactory stimulation test, but not in the late stage. In comparison to controls, autonomic perception and negative affectivity were poorer in MCS patients. These results suggest that prefrontal information processing associated with odor-processing neuronal circuits and memory and cognition processes from past experience of chemical exposure play significant roles in the pathology of this disorder.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- * E-mail:
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, Japan
| | - Hirohisa Takano
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Mari Tanigawa
- Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Division of Internal Medicine, Hyakumanben Clinic, Kyoto, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, Nara, Japan
| | - Ikuko Bamba
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
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Tseng MCM, Lin YP, Hu FC, Cheng TJ. Risks perception of electromagnetic fields in Taiwan: the influence of psychopathology and the degree of sensitivity to electromagnetic fields. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2013; 33:2002-2012. [PMID: 23551091 DOI: 10.1111/risa.12041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Little is known about the perceived health risks of electromagnetic fields (EMFs) and factors associated with risk perception in non-Western countries. Psychological conditions and risk perception have been postulated as factors that facilitate the attribution of health complaints to environmental factors. This study investigated people's perceived risks of EMFs and other environmental sources, as well as the relationships between risk perception, psychopathology, and the degree of self-reported sensitivity to EMFs. A total of 1,251 adults selected from a nationwide telephone interviewing system database responded to a telephone survey about the relationships between environmental sources and human health. The interview included questions assessing participants' psychiatric conditions and the presence and degree of sensitivity to EMFs. One hundred and seventy participants were self-identified as having sensitivity to EMFs, and 141 met the criteria for psychiatric conditions without EMF sensitivity. More than half of the survey respondents considered power lines and mobile phone base stations to affect people's health to a big extent. Higher sensitivity to EMFs, psychopathology, being female, being married, more years of education, and having a catastrophic illness had positive associations with perceived risks of EMF-related environmental sources as well as for all environmental sources combined. We observed no moderating effect of psychopathology on the association between degree of sensitivity to EMF and risk perception. Thus, psychopathology had influence on general people's risk perception without having influence on the relationship between people's degree of sensitivity to EMF and risk perception. The plausible explanations are discussed in the text.
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Affiliation(s)
- Mei-Chih Meg Tseng
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate, Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
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Bogers RP, Bolte JFB, Houtveen JH, Lebret E, van Strien RT, Schipper CMA, Alkadhimi M, Baliatsas C, van Kamp I. Design of an ecological momentary assessment study of exposure to radiofrequency electromagnetic fields and non-specific physical symptoms. BMJ Open 2013; 3:e002933. [PMID: 23988360 PMCID: PMC3758982 DOI: 10.1136/bmjopen-2013-002933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Idiopathic Environmental Intolerance (IEI) attributed to electromagnetic fields (EMF) refers to self-reported sensitivity mainly characterised by the attribution of non-specific physical symptoms to low-level EMF exposure emitted from sources such as mobile phones. Scientific studies have not provided evidence for the existence of IEI-EMF, but these studies did not resemble the real-life situation or suffered from poor exposure characterisation and biased recall of health symptoms. To improve existing methods for the study of IEI-EMF, an Ecological Momentary Assessment (EMA) study is designed. METHODS AND ANALYSIS The study is an EMA study in which respondents carry personal exposure metres (exposimeters) that measure radiofrequency (RF) EMF, with frequent assessment of health symptoms and perceived EMF exposure through electronic diary registration during five consecutive days. Participants will be a selection from an epidemiological study who report to be sensitive to RF EMF. The exposimeters measure electric field strength in 12 frequency bands. Diary questions include the occurrence and severity of 10 non-specific physical symptoms, mood states and perceived exposure to (sources of) EMF. The relationship of actual and perceived EMF exposure and mood with non-specific physical symptoms will be analysed using multilevel regression analysis with time-shift models. DISCUSSION The study has several advantages over previous studies, including assessment of personal EMF exposure and non-specific physical symptoms by an ecological method with a minimised chance of recall bias. The within-person design reduces confounding by time-stable factors (eg, personal characteristics). In the conduct of the study and the analysis and interpretation of its outcomes, some methodological issues including a high participant burden, reactivity, compliance to the study protocol and the potential of chance findings due to multiple statistical testing will be accounted for and limited as much as possible.
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Affiliation(s)
- Rik P Bogers
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Palmquist E, Claeson AS, Neely G, Stenberg B, Nordin S. Overlap in prevalence between various types of environmental intolerance. Int J Hyg Environ Health 2013; 217:427-34. [PMID: 24029726 DOI: 10.1016/j.ijheh.2013.08.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 11/17/2022]
Abstract
Environmental intolerance (EI) is characterized by attribution of several, multisystem symptoms to specific environmental exposures, such as exposure to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs) and everyday sounds. The symptoms are medically unexplained, non-specific and the symptoms overlap between different types of EI. To approach the issue of underlying mechanisms the matter of overlap in prevalence between intolerances can provide valuable information. The aim of the study was to examine if the overlap between intolerance to odorous/pungent chemicals, certain buildings, EMFs and sounds is larger than the expected overlap if no association would exist between them. The study was using cross-sectional data from the Västerbotten Environmental Health Study in Sweden; a large questionnaire-based survey. 8520 adults (18-79 years) were randomly selected after stratification for age and sex, of whom 3406 (40%) participated. Individuals with the four types of intolerance were identified either through self-report, or by having been physician-diagnosed with a specific EI. The overlaps between the four EIs were greater than predictions based on coincidence for both self-reported and diagnosed cases (except for the overlap between diagnosed intolerance to sounds and EMFs). The results raise the question whether different types of EI share similar underlying mechanisms, or at least that the sufferers of EI share some predisposition to acquire the conditions.
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Affiliation(s)
- Eva Palmquist
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
| | | | - Gregory Neely
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden
| | - Berndt Stenberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Steven Nordin
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden
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Facco E, Pasquali S, Zanette G, Casiglia E. Hypnosis as sole anaesthesia for skin tumour removal in a patient with multiple chemical sensitivity. Anaesthesia 2013; 68:961-5. [DOI: 10.1111/anae.12251] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2013] [Indexed: 11/26/2022]
Affiliation(s)
- E. Facco
- Department of Neurosciences University of Padua, and the Italian Center for Clinical and Experimental Hypnosis Turin Italy
| | - S. Pasquali
- Department of Oncological and Surgical Sciences University of Padua Padua Italy
| | - G. Zanette
- Department of Neurosciences University of Padua, and the Italian Center for Clinical and Experimental Hypnosis Turin Italy
| | - E. Casiglia
- Department of Medicine University of Padua, and the Italian Center for Clinical and Experimental Hypnosis Turin Italy
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Abstract
Post-traumatic stress disorder (PTSD) is associated with both (1) 'ill-defined' or 'medically unexplained' somatic syndromes, e.g. unexplained dizziness, tinnitus and blurry vision, and syndromes that can be classified as somatoform disorders (DSM-IV-TR); and (2) a range of medical conditions, with a preponderance of cardiovascular, respiratory, musculoskeletal, neurological, and gastrointestinal disorders, diabetes, chronic pain, sleep disorders and other immune-mediated disorders in various studies. Frequently reported medical co-morbidities with PTSD across various studies include cardiovascular disease, especially hypertension, and immune-mediated disorders. PTSD is associated with limbic instability and alterations in both the hypothalamic- pituitary-adrenal and sympatho-adrenal medullary axes, which affect neuroendocrine and immune functions, have central nervous system effects resulting in pseudo-neurological symptoms and disorders of sleep-wake regulation, and result in autonomic nervous system dysregulation. Hypervigilance, a central feature of PTSD, can lead to 'local sleep' or regional arousal states, when the patient is partially asleep and partially awake, and manifests as complex motor and/or verbal behaviours in a partially conscious state. The few studies of the effects of standard PTSD treatments (medications, CBT) on PTSD-associated somatic syndromes report a reduction in the severity of ill-defined and autonomically mediated somatic symptoms, self-reported physical health problems, and some chronic pain syndromes.
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Affiliation(s)
- Madhulika A Gupta
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
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The feasibility of aromatherapy massage to reduce symptoms of Idiopathic Environmental Intolerance: a pilot study. Complement Ther Med 2012; 20:400-8. [PMID: 23131370 DOI: 10.1016/j.ctim.2012.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 04/23/2012] [Accepted: 07/26/2012] [Indexed: 11/21/2022] Open
Abstract
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.
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Factors associated with prospective development of environmental annoyance. J Psychosom Res 2010; 69:9-15. [PMID: 20630258 DOI: 10.1016/j.jpsychores.2009.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 11/24/2009] [Accepted: 12/01/2009] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Idiopathic environmental intolerance (IEI) has in cross-sectional studies been associated with emotional problems and psychiatric disorders. However, in the absence of prospective studies it has not been possible to determine whether emotional problems precede the onset of IEI, or are a consequence of IEI. The purpose of this study was to address this issue in a prospective panel study design. METHODS The study sample (n=10 275) responded to a postal survey that included five questions regarding annoyance from environmental factors, at baseline and at follow-up five years later. Associations between a number of self-rating scales of stress, subjective health, and working conditions at baseline on one hand, and development of environmental annoyance from baseline to follow-up on the other, were examined. RESULTS Participants having developed environmental annoyance between baseline and follow-up had at baseline reported more subjective health complaints, higher levels of stress, strain, and lack of recovery, more dissatisfaction with their work situation, and lower personal social support, compared to participants not developing environmental annoyance. CONCLUSION Elevated subjective health complaints, high stress in daily life and a strained work situation, all possible signs of sustained arousal, increase the risk of developing annoyance to environmental factors. The results fit the hypothesis that reduced subjective health, over the course of time, may be attributed to environmental factors.
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Skovbjerg S, Zachariae R, Rasmussen A, Johansen JD, Elberling J. Repressive coping and alexithymia in idiopathic environmental intolerance. Environ Health Prev Med 2010; 15:299-310. [PMID: 21432559 DOI: 10.1007/s12199-010-0143-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 03/23/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To examine if the non-expression of negative emotions (i.e., repressive coping) and differences in the ability to process and regulate emotions (i.e., alexithymia) is associated with idiopathic environmental intolerance (IEI). METHODS The study included participants who had previously participated in a general population-based study and reported symptoms of environmental intolerance (n = 787) and patients with IEI (n = 237). The participants completed questionnaires assessing IEI, namely, a measure of repressive coping combining scores on the Marlowe-Crowne Social Desirability Scale (MCSDS) and the Taylor Manifest Anxiety Scale (TMAS), the Toronto Alexithymia Scale (TAS-20), and a negative affectivity scale (NAS). Multiple, hierarchical linear regression analyses were conducted using IEI variables as the dependent variables. RESULTS The TMAS and MCSDS scores were independently associated with the IEI variables, but there was no evidence of a role of the repressive coping construct. While the total alexithymia score was unrelated to IEI, the TAS-20 subscale of difficulties identifying feelings (DIF) was independently associated with symptoms attributed to IEI. Negative affectivity was a strong independent predictor of the IEI variables and a mediator of the association between DIF and IEI. CONCLUSION Our results provide no evidence for a role of repressive coping in IEI, and our hypothesis of an association with alexithymia was only partly supported. In contrast, strong associations between IEI and negative emotional reactions, defensiveness and difficulties identifying feelings were found, suggesting a need for exploring the influence of these emotional reactions in IEI.
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Affiliation(s)
- Sine Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Ledreborg Alle 40, 2.th, 2820, Gentofte, Denmark.
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Skovbjerg S, Zachariae R, Rasmussen A, Johansen JD, Elberling J. Attention to bodily sensations and symptom perception in individuals with idiopathic environmental intolerance. Environ Health Prev Med 2009; 15:141-50. [PMID: 19953345 DOI: 10.1007/s12199-009-0120-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 10/30/2009] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Idiopathic environmental intolerance (IEI) is characterized by non-specific symptoms attributed to exposure to environmental odours or chemicals at levels below those known to induce adverse health effects. A clarification of whether psychological processes involved in sensory perceptions are associated with IEI would add to our understanding of this complex disorder. PURPOSE To examine if measures of somato-sensory amplification, autonomic perception and absorption are associated with IEI. METHODS The study included individuals with self-reported or physician-diagnosed IEI. Participants (n = 732) completed questionnaires that included items on descriptive variables of IEI, the Somato-Sensory Amplification Scale (SSAS), the Autonomic Perception Questionnaire (APQ), the Tellegen Absorption Scale (TAS) and a Negative Affectivity Scale (NAS). RESULTS Multiple, hierarchical linear regression analyses revealed significant positive associations between SSAS, APQ, and IEI, while small and inverse associations were seen between TAS and IEI. CONCLUSIONS The association with SSAS and APQ suggests that perceptual personality characteristics are important in understanding this disorder.
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Affiliation(s)
- Sine Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Ledreborg Alle 40, 2.th, 2820, Gentofte, Denmark.
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Herr C, Otterbach I, Nowak D, Hornberg C, Eikmann T, Wiesmüller GA. Clinical environmental medicine. DEUTSCHES ARZTEBLATT INTERNATIONAL 2008; 105:523-31. [PMID: 19626209 PMCID: PMC2696963 DOI: 10.3238/arztebl.2008.0523] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Accepted: 04/14/2008] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Clinical environmental medicine deals with environmental effects on human health in individual patients. Patients seek medical advice for problems of many different kinds that may be due to environmental exposures; such exposures must be considered carefully along with other potential causes. An environmental medical assessment should include thorough medical history-taking and physical examination, the formulation of a differential diagnosis, and (whenever indicated) human biomonitoring, site inspections, and ambient monitoring. METHODS This review of clinically relevant environment-related health disturbances is based on a selective evaluation of the pertinent literature and of own experiences. RESULTS Overall, relevant environmental exposures can be identified in up to 15% of patients who attribute their health complaints to environmental factors. (Clinical disorders are more common and more severe in these patients.) 40% to 75% are found to suffer from other physical and/or emotional conditions without any specific environmental aspect, i.e., without any apparent or verifiable exposure. DISCUSSION Despite the relative rarity of verifiable environmentally related health disturbances, these must be clearly identified and delimited to avoid further harmful exposures. Environmental medical counseling should include risk assessment and behavior recommendations for all patients who attribute their medical problems to their environment. Physicians performing specific environmental-medical diagnostic procedures must be aware of their limitations in order to avoid performing tests whose results have no therapeutic consequences and are thus of no help to either the physician or the patient.
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Affiliation(s)
- Caroline Herr
- Institut für Hygiene und Umweltmedizin, Justus-Liebig Universität Giessen, Friedrichstrasse 16, Giessen, Germany.
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