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Controversy over Multiple Chemical Sensitivities
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Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
Simon and coworkers' [1] conclusion that psychological symptoms are a central component of multiple chemical sensitivity is unwarranted by their data. By their own admission, “more than one half of the cases did not fulfill criteria for any current psychiatric diagnosis, and almost 25% showed no evidence of clinically significant psychologic distress”. Further, their estimate of 25% as the percentage of patients with “somatization disorder” is questionable because the Diagnostic and Statistical Manual of Mental Disorders [third edition, revised] definition for “somatization disorder” is recursive: Distinguishing between physical and psychological ailments is prerequisite knowledge. We may conclude from Simon and colleagues that 1) a heterogeneous group of predominantly female patients exists who persistently complain and for whom physicians are unable to make any definitive diagnosis [much to the annoyance of physicians who feel that their competence is challenged and their time wasted]; 2) certain immunologic tests do not distinguish patients with putative multiple chemical sensitivity from other patients; 3) some patients with multiple chemical sensitivity suffer psychological disorders that may warrant further investigation and treatment that may not relieve their physical complaints; and 4) physicians use psychiatric diagnoses as a default when they do not know what to do with patients who persistently complain.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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