Interactional behaviour as a marker for screening patients with environment-related complaints

Int J Hyg Environ Health. 2007 Jan;210(1):79-89. doi: 10.1016/j.ijheh.2006.08.003. Epub 2006 Sep 25.


Background: Adequate assessment of symptoms of patients suffering from environmental illnesses requires appropriate procedures such as psychological and psychiatric diagnostics, medical screening and a thorough analysis of noxious environmental factors. The Basel pilot research project established a multi-methodological assessment procedure that meets these criteria. However, an exhaustive three-fold analysis is very costly in terms of both equipment and personnel, and hence the need for a heuristic approach and pre-screening persists.

Method: The three-fold diagnostic approach was preceded by a structured psychodynamic interview; the findings were used to construct a new profile of the patient's interactional behaviour (IB) in conjunction with the interviewer's countertransference. The extent to which this new profile could predict the results of the multi-method assessment was then assessed.

Results: A low level of IB on the part of the patient significantly predicted the degree of stress and the extent of the psychiatric diagnosis, including personality disorders. A negative IB was associated with negative personality traits. Furthermore, a high level of IB implied more medical, but not more environmental, findings which could plausibly be related to the patient's complaints.

Conclusions: Assessment of patients' IB in conjunction with one's own countertransference is very helpful as a preliminary heuristic approach and may lead to consequences for treatment and therapy. Therefore, the training provided for experts who deal with patients suffering from environment-related complaints should place more specific emphasis on assessing patients' behaviour and on incorporating information gathered from countertransference. Nevertheless, an interdisciplinary assessment including medical, psychological/psychiatric, and environmental expertise remains mandatory for adequate and satisfactory diagnosis of patients with environment-related complaints.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Behavior
  • Countertransference*
  • Environmental Illness / diagnosis*
  • Environmental Illness / psychology*
  • Environmental Illness / therapy
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Personality
  • Professional-Patient Relations*
  • Surveys and Questionnaires