Idiopathic environmental intolerances (formerly multiple chemical sensitivity) psychiatric perspectives

Idiopathic environmental intolerances (IEI)/multiple chemical sensitivity ( MCS) is characterized by various somatic symptoms which cannot be explained organically, but are attributed to the influences of toxic environmental c hemicals in low, usually harm-less doses. In the absence of a widely accept ed definition of IEL contradictory aetiological hypotheses and therapeutic suggestions are discussed. Some authors doubt the existence of IEI/MCS as a disease entity of its own. The label IEI does not implicate neither a diag nosis of somatic disease nor that it is caused by an avoidable exposure. Ma ny IEI patients suffer from psychiatric diseases. A majority of them can be diagnosed as somatoform disorders. Consequently, psychiatric therapies cou ld be effective. This review describes the current knowledge about IEI/MCS, outlines a diagnostic algorithm and a psychotherapeutic concept for varian ts of IEI understood as a somatoform. disorder.