SUCCESSFUL MANAGEMENT OF PATIENTS WITH MULTIPLE CHEMICAL SENSITIVITIES ON AN INPATIENT PSYCHIATRIC UNIT

Background: Much controversy exists over the diagnosis, etiology, and treatment of ''multiple chemical sensitivities'' also known as ''envir onmental illness.'' The experience of multiple nonspecific reactions t o numerous environmental agents leads to these diagnoses. Due to skept icism surrounding the validity of these patients' complaints, they are often referred for psychiatric evaluations, but successful management on a psychiatric inpatient unit can be complicated because of their u nique presentations. Method: The approach taken by a university psychi atric inpatient unit to the evaluations of three such patients is pres ented along with a literature review of etiologic theories and treatme nt recommendations. Results: Each of the three patients presented with severe disability from their ''sensitivities,'' but each improved sig nificantly over the course of a 17-day hospitalization. Conclusion: Th ese patients benefited greatly from a serious, nonjudgmental, comprehe nsive approach to the evaluation of their multiple complaints. Despite the absence of any positive organic findings, each felt that her expe riences had been validated, and each subsequently improved. When evalu ating similar patients, clinicians should be aware of useful, effectiv e management strategies and should avoid overt skepticism and confront ation.