Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1995 December; 88(12): 678–679.
PMCID: PMC1295408

Unexplained illness: the mind versus the environment.


Every doctor in clinical practice is familiar with the patient who presents with multiple 'soft' symptoms. Where organic pathology cannot be demonstrated, there is a tendency to apply psychiatric labels. Indeed, it has been suggested that the risk of psychiatric disorder increases linearly with the number of presented symptoms. In psychiatric practice, the mere absence of an organic cause of disease is often regarded as adequate reason to invoke a psychological mechanism. However, this action precludes the possibility of any other diagnosis, and thus constricts therapeutic management to the psychiatric realm. Such psychologization of illness is commonplace, overworked and infrequently challenged. This highlights the longstanding controversy over multiple allergy and the role of psychiatric disorder.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (239K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Howard LM, Wessely S. The psychology of multiple allergy. BMJ. 1993 Sep 25;307(6907):747–748. [PMC free article] [PubMed]
  • Jones VA, McLaughlan P, Shorthouse M, Workman E, Hunter JO. Food intolerance: a major factor in the pathogenesis of irritable bowel syndrome. Lancet. 1982 Nov 20;2(8308):1115–1117. [PubMed]
  • Riordan AM, Hunter JO, Cowan RE, Crampton JR, Davidson AR, Dickinson RJ, Dronfield MW, Fellows IW, Hishon S, Kerrigan GN, et al. Treatment of active Crohn's disease by exclusion diet: East Anglian multicentre controlled trial. Lancet. 1993 Nov 6;342(8880):1131–1134. [PubMed]
  • Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ, Taylor E. Effects of a few food diet in attention deficit disorder. Arch Dis Child. 1993 Nov;69(5):564–568. [PMC free article] [PubMed]
  • Egger J, Carter CM, Wilson J, Turner MW, Soothill JF. Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment. Lancet. 1983 Oct 15;2(8355):865–869. [PubMed]
  • Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Laerum E, Eek M, Mowinkel P, Hovi K, Førre O. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991 Oct 12;338(8772):899–902. [PubMed]
  • Black DW, Rathe A, Goldstein RB. Environmental illness. A controlled study of 26 subjects with '20th century disease'. JAMA. 1990 Dec 26;264(24):3166–3170. [PubMed]
  • Russell M, Dark KA, Cummins RW, Ellman G, Callaway E, Peeke HV. Learned histamine release. Science. 1984 Aug 17;225(4663):733–734. [PubMed]
  • Bolla-Wilson K, Wilson RJ, Bleecker ML. Conditioning of physical symptoms after neurotoxic exposure. J Occup Med. 1988 Sep;30(9):684–686. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press