Polyallergy (Multiple Chemical Sensitivity) is Associated with Excessive Healthcare Utilization, Greater Psychotropic Use, and Greater Mental Health/Functional Somatic Syndrome Disorder Diagnoses: A Large Cohort Retrospective Study

Jiménez, Xavier F.; Shirvani, Nicole; Hogue, Olivia; Karafa, Matt; Tesar, George

doi:10.1016/j.psym.2018.07.016

Cited by 10 publications

(33 citation statements)

References 40 publications

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“…Some authors have argued that MCS diagnosis might be a misdiagnosis of an unrecognized psychiatric disorder [ 31 , 69 ] or a “psychosomatic” illness [ 32 ]. Patients with MCS have an increased likelihood of having a history of psychiatric disorder and a very high rate of psychiatric comorbidity [ 34 , 35 ]. MCS patients significantly showed higher rates of depression and anxiety than the general population, with more frequent lifetime diagnoses of Major Depressive Disorder, generalized anxiety, and panic attacks [ 31 , 70 ].…”

Section: Discussionmentioning

confidence: 99%

“…For some authors, MCS is an unrecognised psychiatric disorder [ 31 ] or a psychosomatic disorder [ 32 ]. This is also based on the increased likelihood of MCS patients having a history of a psychiatric disorder and high rates of psychiatric comorbidities, including depression and anxiety, histrionic personality disorder, panic attacks, and trauma and childhood abuse [ 33 , 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

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Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms

Casale

Ferracuti

Mosca

et al. 2020

IJERPH

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Multiple Chemical Sensitivity (MCS) is a chronic and/or recurrent condition with somatic, cognitive, and affective symptoms following a contact with chemical agents whose concentrations do not correlate with toxicity in the general population. Its prevalence is not well defined; it mainly affects women between 40 and 50 years, without variations in ethnicity, education and economic status. We aimed to assess the core symptoms of this illness in a sample of Italian patients. Two physicians investigated different symptoms with a checklist compilation in 129 patients with MCS (117 women). We conducted a categorical Principal Component Analysis (CATPCA) with Varimax rotation on the checklist dataset. A typical triad was documented: hyperosmia, asthenia, and dyspnoea were the most common symptoms. Patients also frequently showed cough and headache. The CATPCA showed seven main factors: 1, neurocognitive symptoms; 2, physical (objective) symptoms; 3, gastrointestinal symptoms; 4, dermatological symptoms; 5, anxiety-depressive symptoms; 6, respiratory symptoms; 7, hyperosmia and asthenia. Patients showed higher mean prevalence of factors 7 (89.9%), 6 (71.7%), and 1 (62.13%). In conclusion, MCS patients frequently manifest hyperosmia, asthenia, and dyspnoea, which are often concomitant with other respiratory and neurocognitive symptoms. Considering the clinical association that is often made with anxiety, more studies are necessary on the psychosomatic aspects of this syndrome. Further analytical epidemiological studies are needed to support the formulation of aetiological hypotheses of MCS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms

Casale

Ferracuti

Mosca

et al. 2020

IJERPH

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“…33 Prior studies described lower QOL and higher levels of depression, anxiety, alexithymia, and functional somatic syndrome diagnoses in drug allergy patients compared to controls. [34][35][36] Since addressing patient concern is inextricably linked to the real world clinical effectiveness of drug allergy assessments, standard use of mental health measures in drug allergy assessment might help clinicians appropriately target personalized diagnostic approaches for specific patients. For example, a patient with anxiety may benefit from skin testing prior to drug challenge for visual reassurance and/or drug challenges may need to be placebo-controlled.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Patient Characteristics and Concerns about Drug Allergy: A Report from the United States Drug Allergy Registry

Camargo

Zhang

et al. 2020

The Journal of Allergy and Clinical Immunology: In Practice

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“… Abbreviations: DPT, drug provocation test; MASS, multiple antibiotic sensitivity syndrome; MDAS, multiple drug allergy syndrome; MDH, multiple drug hypersensitivity; MDHS, multiple drug hypersensitivity syndrome; MDI, multiple drug intolerance; MDIS, multiple drug intolerance syndrome; PA, polyallergy. a Reference made to ‘drug classes/unrelated drugs’, excluding references to ‘drugs’ included in MDIS2 5 and PA 42 . …”

Section: Results (Tables 1 2 ...mentioning

confidence: 99%

“… 25 MDI was referred to as ADR/intolerance to ≥3 drug classes in two studies. 28 , 42 MDH or MDHS was referred as HSR/allergy to ≥2 drug classes in six studies. 29 , 33 , 34 , 35 , 36 , 41 MASS was referred to as sensitivity to ˃1 drug class in one study.…”

Section: Results (Tables 1 2 ...mentioning

confidence: 99%

Characterization, epidemiology and risk factors of multiple drug allergy syndrome and multiple drug intolerance syndrome: A systematic review

Jagpal

Alshareef

Marriott

et al. 2022

Clinical & Translational All

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Background Multiple drug allergy and multiple drug intolerance syndrome (MDAS/MDIS) labels are an impediment to clinical care and knowledge regarding these conditions is limited. This systematic review investigated the characterization, epidemiology, risk factors, clinical impact and pharmaco‐economics of MDAS and MDIS. Methods Systematic literature search across 11 databases (01 January 2000–06 November 2020) for MDIS, MDAS and related terminology. Studies were reviewed for quality of evidence and risk of bias by employing Critical Appraisal Skills Programme cohort study checklist. A narrative synthesis approach facilitated by systematic textual descriptions, tabulation and thematic analysis was adopted. Results There was heterogeneity in terminology and methodology. Few studies applied standard drug allergy diagnostic methods. There is some evidence to suggest that multiple drug hypersensitivity syndrome (MDHS; i.e., confirmed allergies in MDAS) is a distinct clinical entity. Prevalence of MDIS and MDAS labels in unselected & selected populations varied between 2.1%–6.4% & 4.9%–90% and 1.2% & 0%–36% respectively. Reported risk factors included female gender, increasing age, body mass index, anxiety, depression, co‐morbidities, concurrent allergies and increased healthcare utilization. Drugs commonly implicated were antibiotics and non‐steroidal anti‐inflammatory drugs. No studies relating to clinical impact and pharmaco‐economics were found. Conclusion There is considerable burden of MDAS and MDIS labels. Data needs cautious interpretation as majority of studies described involved unverified labels. Despite this limitation and heterogeneity of studies, there is some evidence to suggest that MDHS is a distinct clinical entity. Well‐designed multi‐centre studies applying standardized terminology and diagnostic methodology are needed to gain further insight into these conditions.

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Polyallergy (Multiple Chemical Sensitivity) is Associated with Excessive Healthcare Utilization, Greater Psychotropic Use, and Greater Mental Health/Functional Somatic Syndrome Disorder Diagnoses: A Large Cohort Retrospective Study

Cited by 10 publications

References 40 publications

Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms

Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms

Patient Characteristics and Concerns about Drug Allergy: A Report from the United States Drug Allergy Registry

Characterization, epidemiology and risk factors of multiple drug allergy syndrome and multiple drug intolerance syndrome: A systematic review

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