Cognitive and Affective Aspects of Multiple Chemical Sensitivities: A Case Study

A male patient was referred to an occupational medicine clinic for evaluation of a variety of medical, neuropsychological, and psychiatric complaints, including headaches, fatigue, impotence, attention and short-term memory problems, and depression. These complaints followed his exposure to a coolant that was used in his work as a tool-and-die maker, and the symptoms persisted after his transfer to another department. A medical evaluation revealed no organic basis for his continuing symptoms. Neuropsychological testing showed no evidence of an underlying neurological disorder but did reveal significant signs of depression and personality disturbance. The case is discussed in the context of a newly recognized clinical entity termed multiple chemical sensitivities (MCS), and it illustrates the value of extensive neuropsychological assessment and a thorough medical evaluation in the diagnosis and management of this disorder.