A Study on Multiple Chemical Sensitivities from Psychosomatic Perspectives (Paneldiscussion II/Allergic Diseases and Psychosomatic Medicine)

The multiple chemical sensitivities (MCS), a concept advocated by Cullen (1987), refers to a syndrome induced after low-dose but continuous exposure or high-dose and one-time exposure to various chemicals. The concept of MCS is not yet generally accepted and there is much debate even on the name of the syndrome. The objective of this study is to clarify the relationship between stress-related factors and MCS from psychosomatic perspectives. Subjects : We surveyed 18 patients with MCS (male; n=7,female; n=11,) and 35 controls (male;n=7,female; n=28) to investigate the effects of stress-related factors on MCS. The patients were diagnosed as having MCS in the Clinical Environmental Center of the Kitasato Institute Hospital. We recruited controls through an advertisement on a family magazine, who are healthy persons aged 20-70 without medication, and not diagnosed as having sick-building syndrome in spite of having moved to a new house or a reformed house during the past three years. Fulfilling these requirements, the controls were considered not suffering from MCS under continuous exposure to low-dose chemicals. Measurements : All subjects underwent the life health questionnaire (LHQ) which evaluates life events, daily hassles, social support, stress coping, smoking and drinking habit, physical, mental and behavioral stress responses. They were also examined for the following tests : The Cornell Medical Index-health questionnaire (CMI) for physical and psychiatric subjective symptoms, the Profile of Mood States (POMS), the Eysenck Personality Questionnaire-Revised (EPQ-R), the Twenty-Item Toronto Alexithymia Scale-Revised (TAS-20R), the Somatosensory Amplitude Scale (SSAS) and the Tri-Axial Coping Scale (TAC-24). They were also examined for the heart rate variability as the function of autonomic nervous system. In order to diagnose psychiatric comobidity, one psychosomatic doctor interviewed all of them by using the Mini-International Neuropsychiatric Interview and the items of somatoform disorders extracted from the Structured Clinical Interview for DSM-IV. Results : The scores of life events during the past one year and the present stress scores of patients were significantly higher than those of controls. However, there was no Significant difference recognized in specific personality trend or stress-coping style. A remarkable difference was noted in the volume of smoking and alcohol drinking in the past One month. No patients had smoked at all and few patients had drunk alcohol. After occurrence of MCS, the patients felt various physical and psychological symptoms. The rate of psychiatric comobidity of patients was 83%, while 11% of controls. The details of psychiatric diagnoses on the patients were Somatoform Disorders (67%), Mood Disorders (61%), Anxiety Disorders (50%) and so on. As for the heart rate variability as the function of autonomic nervous system, there was no difference between patients and controls. Conclusion : Psychological stress may promote the occurrence of MCS, but there was no distinctive psychological or behavioral profile of patients except that they smoked or dranked less. And MCS patients had many psychiatric comobidities.