Psychiatric perspective of persons with “Environmental illness”

Abstract

Clinical ecologists, a group of nontraditional physicians, have described a condition that they believe to be common, frequently unrecognized, and potentially disabling or even life threatening (1-5). They believe the condition is caused by an exquisite sensitivity to substances in our environment that are normally well tolerated and is characterized by a variety of ill-defined symptoms affecting nearly every organ system. These agents (or incitants) include common foods, organisms (e.g., Candida albicans), and organic chemicals (e.g., volatile hydrocarbons). Various terms have been used to describe the condition, which has added to the confusion about it among medical practitioners and the lay public. The most frequently used term "environmental illness" (EI) follows from the belief that environmental agents are the causative factors (2). The condition is also called "multiple chemical sensitivity," a term that recognizes that sensitivity to different chemical agents is a defining feature of the disorder (1). Other terms are more descriptive of the form that the illness is thought to take. Because clinical ecologists have focused on allergic mechanisms, many of their terms reflect this aspect, including "allergic to everything" and "total environmental allergy." Many clinical ecologists have blamed abnormal immune mechanisms as a cause of symptoms, and some terms reflect these beliefs (e.g., "immune dysregulation syndrome," "chemical AIDS"). Other terms have focused on the seemingly new aspect of the illness (e.g., "20th-century disease, .... ecologic illness"). Some patients are thought to be primarily sensitive to C. albicans and are thought to have "candidiasis" or "yeast disease" (5). The common ground in all of