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A Controlled Study of 26 Subjects With '20th Century Disease'

Donald W. Black, MD; Ann Rathe, BA; Rise B. Goldstein, MSW, MPH

JAMA. 1990;264(24):3166-3170.

Abstract
Environmental illness is a polysymptomatic disorder believed by "clinical ecologists" to result from immune dysregulation brought on by common foods and chemicals. We systematically evaluated 26 subjects who had been assigned a diagnosis of environmental illness. The subjects indicated a strong interest in their diagnosis, were generally satisfied with their clinical ecologist, and were dissatisfied with traditional medical approaches. Subjects reported varying treatments, including dietary restrictions, avoidance of offending agents, and physical treatments. Using the Diagnostic Interview Schedule, we found that 15 (65%) of 23 subjects met criteria for a current or past mood, anxiety, or somatoform disorder compared with 13 (28%) of 46 age- and sex-matched community controls. We conclude that patients receiving this diagnosis may have one or more commonly recognized psychiatric disorders that could explain some or all of their symptoms.

(JAMA. 1990;264:3166-3170)

Author Affiliations
From the Department of Psychiatry, University of Iowa College of Medicine, Iowa City.

Footnotes
Reprint requests to the Department of Psychiatry, University of Iowa College of Medicine, 500 Newton Rd, Iowa City, IA 52242 (Dr Black).

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