THE ENVIRONMENTAL SOMATIZATION SYNDROME

Patients with environmental somatization syndrome (ESS) believe that t heir symptoms are caused by exposure to tangible components of the ext ernal environment or by ergonomic stress at work. ESS is distinguishab le by mental contagiousness and by the patients' focus on the external environment as cause of the illness. The presentation is often polysy mptomatic, and epidemic outbreaks may appear. The patients usually ref use alternative explanations of their symptoms and discredit and rejec t any suggestion of a psychogenic etiology. It is important to disting uish between hygienic problems and ESS problems, particularly when poo r and inadequate hygienic factors are present simultaneously with an E SS epidemic.