Since symptoms typical for multiple chemical sensitivity (MCS) are induced by exposure to low levels of chemicals, we hypothesize that MCS represents an impaired recognition of odors or an increased emotional reaction to common odors. Twenty-five subjects with MCS, 20 women and 5 men, and 50 gender-and-age matched controls participated in this study. The University of Pennsylvania Smell Identification Test (UPSIT) and the Cross-Cultural Smell Identification Test (CC-SIT) were administered. In addition to selecting the most probable odor among the four, the subjects were asked their impression of each odor. Odor identifiability evaluated by the scores of two tests, were almost equal in MCS and control groups. The mean CC-SIT odor per person with pleasant feeling was lower in MCS than in controls. The mean odor per person creating an unpleasant sensation was higher in MCS than in the controls. Gingerbread was the only odor making MCS subjects more pleasant than the controls. Nine out of 40 UPSIT odors were felt as unpleasant by MCS subjects more than by controls. This study indicates that MCS subjects are able to identify the odors equally as well as the controls but feel unpleasant to a larger number of odors than the controls. Despite unknown mechanisms of the altered odor perception in MCS, the application of these tests for diagnostic procedure of MCS is proposed.

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Cases with multiple chemical sensitivity (MCS) frequently present mental symptoms. This study discusses the characteristics of the anxiety and depressive state of MCS by comparing patients of MCS with a gender and age-matched control group. In this investigation, MCS cases were selected among those satisfying the diagnostic criteria of Cullen after ruling out other physical diseases. Patients visiting ophthalmologists with other diseases were designated as the control. Evaluation of the anxiety and depressive state was performed in 48 cases of MCS and 48 controls using the Japanese version of the State-Trait Anxiety Inventory, the Self-rating Depression Scale (SDS), and the Hamilton Rating Scale for Depression. Significantly higher mean values of subjective anxiety and a depressive state were obtained in 18 MCS cases than in 18 controls for the follow-up patients, while no significant difference was observed between MCS and controls of 30 new patients for each group. Therefore, anxiety in MCS is characterized by the continuous high anxiety level. MCS is also characterized by a continuance of depressive state at a "neurotic level" category by SDS. The anxiety scores and depressive levels were highly correlated in MCS and controls at the first and subsequent appearances, except those in the follow-up control cases. In conclusion, both anxiety and a depressive state in MCS remained at high level until the subsequent examination, when those in controls decreased to a normal level.

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