The influence of health beliefs on the presentation and consultation outcome in patients with chemical sensitivities

Objective: This study was carried out to investigate the impact of the phys ical effects of a chemical exposure, health and chemical beliefs, and chemi cal sensitivities treatment preferences on the consultation outcome at a te rtiary liaison clinic. Method: Eighty-five patients exposed to a range of c hemicals were assessed at a joint: medical toxicology and psychiatric clini c. Patient's beliefs about chemicals and health, chemical sensitivities and their treatment preferences were assessed using a 23-item questionnaire. R esults: Fifty-seven patients (69%) had suffered from a range of initial or delayed symptoms that were probably a clear physical consequence of the exp osure (Group A), whereas 26 patients (31%) had not (Group B). There were no significant differences found between groups A and B in terms of their dia gnosis and their beliefs about health, food, chemicals and chemical sensiti vities treatment preferences. However, patients in Group A were significant ly more likely to report moderate to severe symptoms in comparison to Group B. Consultation outcome too did not differ between the two groups. The onl y predictors of consultation outcome were the patients' chemical sensitivit ies treatment preferences. Patients who at the outset thought that their tr eatment should comprise of complete avoidance to chemicals, regular monitor ing and the use of alternative rather than conventional medicine were signi ficantly less likely to achieve a favourable consultation outcome. Patients ' chemical sensitivities treatment preferences were related to the more gen eral beliefs on health, food and the harmful nature of chemicals and were n ot related to the chemical exposure variables. Conclusion: These findings s uggest that addressing patients' treatment preferences and the general beli efs on chemicals, food and health may enhance outcome and perhaps ought to be the target for intervention in context of such a liaison clinic. (C) 200 1 Elsevier Science Inc. All rights reserved.