Background: Diagnostics and therapy of environmentally related disorders are hampered by one-sided assumptions and by discrepancies between therapists' and patients' assessments of the disease cause.
Objectives: Discrepancies between patient and expert opinions are examined as to (1) whether the sample can be classified in subgroups according to the convergence or divergence between self and expert rating, (2) which features and (3) which disorder-related behaviour and concepts characterize these groups.
Methods: Medical, psychopathological and environmental symptoms were assessed and their relative influence evaluated. Four subgroups were defined by differentiating between high and low psychological stress according to self and expert judgment, and then compared using statistical and qualitative methods.
Results: 61 patients were assessed and assigned to four different subgroups according to the number of psychiatric diagnoses, psychological conflicts, personality structure, environmental exposure and psychosocial integration.
Conclusions: Diagnostics of environmentally related disorders must be based on interdisciplinary tools. Treatment should incorporate the individual patient's conception of his or her disorder.