Immunologic, Psychological, and Neuropsychological Factors in Multiple Chemical Sensitivity: A Controlled Study

Simon, Gregory E.; Daniell, William; Stockbridge, Henry; Claypoole, Keith H.; Rosenstock, Linda

doi:10.7326/0003-4819-119-2-199307150-00001

Cited by 172 publications

(100 citation statements)

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“…Inhaled CO 2 has been shown to trigger panic symptoms in 48-92% of patients with PD and approximately 5% of normal controls (20,21). In our study, responses to a single-breath inhalation of 35% CO 2 and a single breath of air alone (delivered in a single-blind manner) were compared in 36 subjects with IEI [fulfilling criteria described by Simon et al (8)] and 37 healthy controls. Subjects given a diagnosis of IEI were excluded from the study if they had a previous psychiatric diagnosis or were taking psychiatric medications.…”

Section: Panic Responses In Idiopathic Environmental Intolerancementioning

confidence: 99%

“…A central question has been whether individuals characterized with IEI suffer from a toxic or allergic disorder or whether psychological factors cause at least some to develop physical symptoms that they attribute to allergy or toxic mechanisms. Because allergy has not been clearly demonstrated and current toxicological paradigms for exposure-symptom relationships do not readily accommodate IEI, psychogenic theories have been the focus of a number of investigations (7)(8)(9).…”

mentioning

confidence: 99%

“…Several investigators found increased psychiatric morbidity among IEI patients (7)(8)(9)(10)(11)(12). Simon et al (8) reported a greater prevalence of current anxiety or depressive disorders among patients with IEI than among controls with chronic musculoskeletal injuries.…”

mentioning

confidence: 99%

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Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder.

Tarlo

Poonai

Binkley

et al. 2002

Environ Health Perspect

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Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity, is a clinical description for a cluster of symptoms of unknown etiology that have been attributed by patients to multiple environmental exposures when other medical explanations have been excluded. Because allergy has not been clearly demonstrated and current toxicological paradigms for exposure-symptom relationships do not readily accommodate IEI, psychogenic theories have been the focus of a number of investigations. A significantly higher lifetime prevalence of major depression, mood disorders, anxiety disorders, and somatization disorder has been reported among patients with environmental illness compared with that in controls. Symptoms often include anxiety, lightheadedness, impaired mentation, poor coordination, breathlessness (without wheezing), tremor, and abdominal discomfort. Responses to intravenous sodium lactate challenge or single-breath inhalation of 35% carbon dioxide versus a similar breath inhalation of clean air have shown a greater frequency of panic responses in subjects with IEI than in control subjects, although such responses did not occur in all subjects. Preliminary genetic findings suggest an increased frequency of a common genotype with panic disorder patients. The panic responses in a significant proportion of IEI patients opens a therapeutic window of opportunity. Patients in whom panic responses may at least be a contributing factor to their symptoms might be responsive to intervention with psychotherapy to enable their desensitization or deconditioning of responses to odors and other triggers, and/or may be helped by anxiolytic medications, relaxation training, and counseling for stress management.

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Section: Panic Responses In Idiopathic Environmental Intolerancementioning

confidence: 99%

mentioning

confidence: 99%

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Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder.

Tarlo

Poonai

Binkley

et al. 2002

Environ Health Perspect

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“…Only two studies to date have used standardized neuropsychological tests to evaluate the cognitive complaints of MCS patients (50,56 (57,58). These patients are similar to MCS patients in that they are otherwise healthy individuals who report sensitivities in response to indoor air mixtures that other individuals apparently tolerate.…”

Section: Individual Susceptibilitymentioning

confidence: 99%

“…This finding is consistent with the observation of hyperactive children of Weiss et (Figure 2). Health concerns measures a range of somatic symptoms, some of which can be related to neurologic conditions and some to somatization (69 (50,56). Little is known about how depression may interact with the effects of neurotoxicants in producing behavioral performance decrements.…”

Section: Individual Susceptibilitymentioning

confidence: 99%

Neuropsychological approaches for the detection and evaluation of toxic symptoms.

Fiedler

1996

Environ Health Perspect

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Multiple Chemical Sensitivity Syndrome

Black¹,

Doebbeling²,

Voelker³

et al. 2000

Arch Intern Med

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Objective: To assess the prevalence of and risk factors for self-reported symptoms suggestive of multiple chemical sensitivities/idiopathic environmental intolerance (MCS/IEI) in Persian Gulf War (PGW) veterans from Iowa and a comparison group of PGW-era military personnel.Methods: A population-based sample of Iowa military personnel was surveyed using a cross-sectional telephone interview. Study participants were randomly drawn from 1 of 4 domains: PGW active duty, PGW National Guard/Reserve, non-PGW active duty, and non-PGW National Guard/Reserve. A complex sample survey design was used selecting participants from the following substrata: age, sex, race, rank, and military branch. The criteria for MCS/IEI were developed using expert consensus and the medical literature.Results: A total of 3695 study participants (76% of those eligible) completed the telephone survey. The prevalence of symptoms suggestive of MCS/IEI in all participants was 3.4%. Veterans of the PGW reported a significantly higher prevalence of symptoms suggestive of MCS/IEI than did non-PGW military personnel (5.4% vs 2.6%); greater sensitivity to organic chemicals, vehicle exhaust, cosmetics, and smog; and more lifestyle changes. The following risk factors for MCS/IEI were identified with univariate analysis: deployment to the Persian Gulf, age (Ͼ25 years), female sex, receiving a physician diagnosis of MCS, previous professional psychiatric treatment, previous psychotropic medication use, current psychiatric illness, and a low level of preparedness. Multiple logistic regression analysis identified several independent risk factors for MCS/IEI, including deployment to the Persian Gulf, age, sex, rank, branch of service, previous professional psychiatric treatment, and current mental illness.Conclusions: Self-reported symptoms suggestive of MCS/IEI are relatively frequent in a military population and are more common among PGW veterans than comparable controls. Reported chemical sensitivities and accompanying behavioral changes were also frequent. After adjusting for age, sex, and training preparedness, previous professional psychiatric treatment and previous psychotropic medication use (before deployment) showed a robust association with symptoms suggestive of MCS.

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Immunologic, Psychological, and Neuropsychological Factors in Multiple Chemical Sensitivity: A Controlled Study

Cited by 172 publications

References 0 publications

Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder.

Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder.

Neuropsychological approaches for the detection and evaluation of toxic symptoms.

Multiple Chemical Sensitivity Syndrome

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