David A. Katerndahl|Iris R. Bell|Robert E. A. Palmer|Claudia S. Miller
Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes
The University of Texas Health Science Center at San Antonio|University of Arizona|The University of Texas Health Science Center at San Antonio|The University of Texas Health Science Center at San Antonio
study extends previous communitybased studies prevalence clinical characteristics chemical intolerance sample primary care clinic patients evaluated comorbid medical psychiatric disorders functional status rates health care usea total 400 patients recruited 2 family medicine clinic waiting rooms san antonio texas patients completed validated quick environmental exposure sensitivity inventory qeesi assess chemical intolerance primary care evaluation mental disorders primemd screen possible psychiatric disorders dartmouthnorthern new england primary care cooperative information project dartmouth coop charts functional status healthcare utilization questionnaireoverall 203 sample met criteria chemical intolerance chemically intolerant group reported significantly higher rates comorbid allergies often met screening criteria possible major depressive disorder panic disorder generalized anxiety disorder alcohol abuse disorder well somatization disorder total number possible mental disorders correlated chemical intolerance scores p 001 controlling demographics patients chemical intolerance significantly likely poorer functional status trends toward increased medical service use compared nonchemically intolerant patients controlling comorbid psychiatric conditions groups differed significantly regarding limitations social activitieschemical intolerance occurs 1 5 primary care patients yet rarely diagnosed busy practitioners psychiatric comorbidities contribute functional limitations increased health care use chemical intolerance offers etiologic explanation symptoms may resolve improve avoidance salient chemical dietary including caffeine alcohol drug triggers given greater medication intolerances chemical intolerance primary care clinicians could use qeesi identify patients appropriate triage comprehensive nonpharmacologic care