Psychogenic Origins of Multiple Chemical Sensitivities Syndrome: A Critical Review of the Research Literature

Abstract

The purpose of this review was to critically evaluate research on the psychogenic origins of multiple chemical sensitivities (MCS) syndrome. Using as keywords environmental illness, multiple chemical sensitivities, and clinical ecology, two databases--PsychLit and Medline--were searched by computer; reference lists of all articles located were also searched manually. Ten articles meeting three criteria were selected for review. Five sample selection problems, seven measurement problems, and three study design problems were common in all but one of the articles reviewed. Current studies investigating psychogenic hypotheses of MCS syndrome are methodologically problematic and their conclusions questionable. Studies of psychiatric profiles observed in MCS syndrome need to be designed to differentiate between competing psychogenic and biogenic hypotheses.

A review of a two-phase population study of multiple chemical sensitivities.

“…These psychologically based studies speculate that hypersensitivity to low levels of chemicals may be a somatization disorder (Black et al 1990) or a conditioned response (Siegel and Kreutzer 1997). Psychogenic theories, however, have been criticized for methodologic weaknesses, such as biased patient selection and the lack of presymptom data (Davidoff and Fogarty 1994). Miller and Mitzel (1995) conducted an experiment that investigated the genesis and other aspects of chemical sensitivity.…”

Profile of Patients with Chemical Injury and Sensitivity

“…These (41)(42)(43). Since depression and mood swings can occur with solvent/hydrocarbon exposures and with porphyrin disturbances, these are not in themselves evidence of a psychologic etiology of MCS (40). These and other studies strongly suggest that chemical sensitivity is a physiologic not a psychologic disorder (35,36,44).…”

“…Chemical sensitivity has been reported in the literature following exposure to chlordane (14), chlorpyrifos (37), pesticides (38), formaldehyde (39), tight or sick buildings (15), and organophosphates and solvents (40). These (41)(42)(43).…”

Clinical characteristics of chemical sensitivity: an illustrative case history of asthma and MCS.

“…It is of interest that the patient had a psychotic and agitated response to steroids, which is similar to the neurocognitive or emotional instability reported by MCS patients at times in response to chemical exposures. Some authors have ascribed such symptoms in chemically sensitive patients to psychiatric diagnoses (17)(18)(19), but the validity of these conclusions has been seriously questioned in a recent critical review (5). Moreover, an animal model has been recognized that can explain many of the features of such an illness on a physiological basis of time-dependent sensitization and limbic kindling or other neurological sensitization (7,(20)(21)(22)(23).…”

“…The characteristic clinical features of chemical sensitivity, which includes such factors as demographic data, frequency of symptoms, and theories of pathogenesis, have been described by several authors (1)(2)(3)(4)(5)(6)(7)(8) had been an inpatient in a tertiary care hospital from May until November 1991. She had been diagnosed with intractable asthma and laryngeal stridor, and was receiving continuous intravenous infusion of epinephrine through a subclavian central venous line.…”