A controlled comparison of multiple chemical sensitivities & Chronic Fatigue Syndrome (CFS)

The present study had two objectives: 1) to determine the

characteristics that differentiated subjects with multiple

chemical sensitivities (MCS), chemical sensitivities (CS), and

chronic fatigue syndrome (CFS); and 2) to evaluate the

psychiatric and neuropsychological complaints of these groups

relative to normal controls.

A cross-sectional comparison was

made of the following groups matched for age, sex, and

education: 1) patients whose sensitivities to multiple low

level chemical exposures began with a defined exposure (MCS; N

= 23); 2) patients with sensitivities to multiple chemicals

without a clear date of onset (CS; N = 13); 3) patients

meeting CDC criteria for Chronic Fatigue Syndrome (CFS; N =

18); and 4) normal controls (N = 18). Subjects with

sensitivities to chemicals (MCS and CS) reported significantly

more lifestyle changes due to chemical sensitivities and

significantly more chemical substances that made them ill

compared with chronic fatigue and normal controls. MCS, CS,

and CFS patients had significantly higher rates of current

psychiatric disorders than normal controls and reported

significantly more physical symptoms with no medical

explanation. Seventy-four percent of MCS and 61% of CFS did

not qualify for any current Axis I psychiatric diagnosis.

Chemically sensitive subjects without a defined date of onset

(CS) had the highest rate of Axis I psychiatric disorders

(69%). On the MMPI-2, 44% of MCS, 42% of CS, 53% of CFS, and

none of the controls achieved clinically significant

elevations on scales associated with somatoform disorders.

With the exception of one complex test of visual memory, no

significant differences were noted among the groups on tests

of neuropsychological function. Standardized measures of

psychiatric and neuropsychological function did not

differentiate subjects with sensitivities to chemicals from

those with chronic fatigue. Subjects with sensitivities to

chemicals and no clear date of onset had the highest rate of

psychiatric morbidity. Standardized neuropsychological tests

did not substantiate the cognitive impairment reported

symptomatically. Cognitive deficits may become apparent under

controlled exposure conditions.

Fiedler N, Kipen HM, DeLuca J, Kelly-McNeil K, Natelson B

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