Personality styles of patients asserting environmental illness.

Case reports and chart reviews of patients asserting environmental illness suggest that they suffer from psychiatric difficulties, typically somatization disorder. We assert that viewing these patients solely as somatizers or hysterical characters searching for a nurturant relationship will undermine the doctor-patient relationship. Rather, many of these patients are obsessive/paranoid characters searching for a medical explanation to their physical symptoms. This distinction is highlighted by contrasting the clinical presentations of hysteric/somatizing patients with those environmental illness patients demonstrating an obsessive/paranoid style. Further illustration is provided by a case report with psychological test data. Finally, treatment recommendations based upon this distinction are delineated.