Syndromes in environmental medicine: Variants of somatoform disorders?

Concerning the syndromes in environmental medicine, like Multiple Chemical Sensitivities (MCS), Idiopathic Environmental Intolerances (IEI), Sick Buil ding Syndrome (SBS), Chronic Fatigue Syndrome (CFS), Candida Syndrome (CS), and Burnout Syndrome (BS), scientific knowledge in etiology, pathology, pa thophysiology, diagnosis, therapy, prevention and prognosis is still lackin g until now. A critical comparison shows that it is still impossible to fin d a scientifically satisfying delimitation. Syndromes in environmental medi cine show clinical similarities to somatoform disorders. Furthermore, there are the following possible explanations for the existence of these syndrom es: Firstly, they may be a complex interaction of environmental impacts, in dividual predispositions, psychological influences, as well as processes of mental perception and interpretation. Secondly, they may be an effect of d istress influenced by culture and social structures and/or thirdly, they ma y be an iatrogenic determination. A more comprehensive characterisation whi ch better considers the complex clinical manifestations is overdue. Althoug h there are neither scientifically validated procedures for diagnosis or th erapy nor prophylactic measures, a hardly comprehensible number of partly u nvalidated methods is in practical use. Until the syndromes are not Finally defined the terms for the syndromes should not be applied to a certain dis ease. Despite all uncertainities in the evaluation of syndromes in environm ental medicine, physicians have the duty to take the affected persons' prob lems seriously.