Psychological predictors of short- and medium term outcome in individuals with idiopathic environmental intolerance OED and individuals with somatoform disorders
Psychological predictors of short- and medium term outcome in individuals with idiopathic environmental intolerance OED and individuals with somatoform disorders
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DOI：
10.1080/15287390801985562
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发表时间：
2008-01-01
影响因子：
2.6
通讯作者：
Rist, Fred
中科院分区：
文献类型：
--
作者：
Bailers, Josef;Witthoeft, Michael;Rist, Fred
特发性环境不耐受（IEI），也称为多种化学物质敏感性（MCS），被定义为一种无法用器质性疾病解释的慢性多症状病症。先前的研究表明，IEI可能是躯体形式障碍（SFD）的一个变体，因为这两种障碍在躯体化的症状和心理特征方面重叠。然而，关于IEI的短期和中期结果以及心理结果预测因子知之甚少。两个临床组（IEI和SFD）和对照组（CG）随访32个月，以评估结果，以及特质焦虑和躯体症状归因（首次检查时评估）预测12个月和32个月后结果的程度。结果的措施是自我报告的IEI症状，IEI触发，IEI相关的功能障碍和躯体形式症状的数量。此外，在32个月的随访期内，采用标准化筛选量表对2种综合征的病程进行了研究。3个诊断组包括46例IEI受试者、38例SFD但无IEI受试者和46例既无IEI也无SFD受试者（CG）。在32个月的随访期内，综合征的稳定性很高，在两次随访中，IEI和非IEI受试者在所有IEI结局指标（症状、触发因素、功能障碍）上都不同。特质焦虑和躯体归因（将常见的躯体症状归因于疾病的倾向）均可预测结果。此外，躯体归因被发现部分介导特质焦虑对IEI组结果的影响。总之，这些结果表明，IEI是一种慢性和禁用条件和特质焦虑有助于通过躯体归因的障碍的维护。
Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity (MCS), is defined as a chronic polysymptomatic condition that cannot be explained by an organic disease. Previous studies suggest that IEI may be a variant of somatoform disorders (SFD), because both disorders overlap with respect to symptoms and psychological features of somatization. However, little is known about the short- and medium-term outcome of IEI and psychological outcome predictors. Two clinical groups (IEI and SFD) and a comparison group (CG) were followed through 32 mo to assess both the outcome, and the extent to which trait anxiety and somatic symptom attribution (assessed at first examination) predict outcome presented 12 and 32 mo later. Outcome measures were the number of self-reported IEI symptoms, IEI triggers, IEI-associated functional impairments, and the number of somatoform symptoms. In addition, the course of the 2 syndromes over the 32-mo follow-up period was investigated with standardized screening scales. The 3 diagnostic groups consisted of 46 subjects with IEI, 38 subjects with SFD but without IEI, and 46 subjects (CG) with neither IEI nor SFD. Syndrome stability was high over the 32-mo follow-up period, and at both follow-ups IEI and non-IEI subjects differed on all IEI outcome measures (symptoms, triggers, functional impairments). Both trait anxiety and somatic attribution (the tendency to attribute common somatic complaints to an illness) predicted outcome. In addition, somatic attribution was found to partially mediate the effect of trait anxiety on outcome in the IEI group. In conclusion, these results suggest that IEI is a chronic and disabling condition and that trait anxiety contributes to the maintenance of the disorder via somatic attributions.