[Environmental somatization syndrome. How to deal with the external milieu syndrome?].

Somatization is a tendency to experience and communicate psychogenic distress in the form of somatic symptoms and to seek medical help for them. Patients suffering from environmental somatization syndrome (ESS) consider their symptoms to be caused by exposure to chemical or physical components of the external environment or by ergonomic stress at work. ESS is distinguished by mental contagiousness and a tendency to cluster. Sometimes it explodes in wide-spread epidemics that may be escalated by mass-media campaigns. Extensive ESS epidemics have been connected to, i.a., arsenic, carbon monoxide ("generator gas poisoning"), mercury ("oral galvanism"), carbon-free copy papers, electromagnetic fields ("electric allergy") and repetitive movements ("repetition strain injury", RSI). The typical patient directs the interest on the external environment, refuses alternative explanations of his symptoms and abhors any suggestion of a psychogenic etiology. The community is often placed in difficult positions by lobby groups calling for drastic measures to eliminate alleged disease-inducing exposures. When hygienic evils occur simultaneously with an ESS epidemic, it is essential to strictly differ the hygienic problems from the ESS problems. If mismanaged, measures aimed at reducing hygienic inconveniences may aggravate the complex of ESS problems.