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Recent reports have pointed to an increased number of patients presenting with multisystem symptoms which they attribute to chemical exposures or to heightened chemical sensitivity. Twenty patients exposed to wood preservative products, who attended a joint toxicology and psychiatric clinic, were reviewed by a retrospective case note analysis. Thirteen patients attributed their symptoms to the wood preservative soon after the exposure, and seven patients developed the attribution only at a later date. Reported symptoms referred to all body systems, but there were few physical signs. Clinical findings suggest that the acute symptoms were consistent with the expected toxic effects, but the chronic symptoms could not be explained physically. Patient's beliefs about chemical poisoning could be understood as arising in the context of an attributional process, representing a sociopsychosomatic syndrome precipitated by wood preservative exposure. Patient management included a discussion of findings from assessments, published information, along with counseling where appropriate. Follow-up information from their general practitioners indicated a possible improvement in 50% of patients.

Sixty-two gynaecology in-patients were screened for psychiatric disorder and illness behaviour on the eve of elective laparoscopy. Patients with chronic pelvic pain (CPP) reported significantly more depressed mood and illness behaviour than those without pain. Chronic pelvic pain patients with relevant structural pathology at laparoscopy were compared to those with negative laparoscopic findings. The two groups did not differ on measures of psychiatric morbidity or illness behaviour. They differed significantly in response to the McGill Pain Questionnaire. These findings were used to propose a self-report instrument for predicting negative laparoscopic findings in depressed CPP patients pre-operatively.

Eysenck Personality Questionnaires were completed by a consecutive series of 60 soldiers attending a military endoscopy clinic. Each individual was pair-matched with a non-endoscoped soldier from a medical ward and a soldier from the hospital alcohol treatment unit. Alcohol dependence and related disabilities were measured using the MAST, CAGE and SADQ questionnaires and liver function tests and MCV estimates were performed. Alcohol questionnaire scores and laboratory tests were analysed by discriminant function analysis and by applying 'cut-off' scores of the questionnaires. Analyses of the personality dimensions were carried out by analyses of variance and were examined in relation to sample, alcohol questionnaire scores and endoscopic findings. The soldiers from the alcohol treatment unit had the highest neuroticism score, followed by the soldiers attending the endoscopy clinic. Of the endoscoped soldiers, those diagnosed as non-ulcer dyspeptics had higher neuroticism scores than soldiers with ulcers. This finding was not associated with increased prevalence of alcohol dependence and related disabilities.

Ratings of sexual behaviour and feelings were obtained regularly from subjects of a longitudinal study of psychiatric status and psychological change in pregnancy and the first postnatal year. The results are consistent with previous research, showing a reduction in frequency of sexual intercourse and in interest and satisfaction with sex over the course of pregnancy. Coitus was resumed after childbirth within six weeks by nearly 60% of women, and within three months by eighty. In most cases, ratings of interest in and satisfaction with sex also returned to early pregnancy levels by three months postnatal. Despite clear trends in the group as a whole there was considerable individual variation, investigated using tests of association with measures of subject characteristics and psychological status.

This paper briefly explores the following propositions: People usually attend their doctors with complaints of individual functioning. Sometimes these indicate malfunctioning of the individual concerned; this malfunction may be in the somatic domain or in the psychological sphere or may appear to be the former but in reality be the latter. Two other possibilities are also important, namely that a complaint of individual functioning may be occasioned by an external circumstance, or may be an indication of disorder in the family system or some component of it. In these instances it may be more profitable to focus upon the troublesome event or the system disturbance rather than on the individual complaints and if this is done the individual complaints may subside. A procedure is suggested which is different to the one commonly followed but which might be worth exploring. The usual procedure is to examine the possibility of somatic disturbance first. It seems likely that bodily complaints are more commonly indicants of event difficulty or system disorder than of bodily malfunction and when symptoms do not immediately draw attention to a well defined illness process, it is suggested that consideration be given to the possibility of joint meetings with all the relevant persons who may be supposed to be concerned in the systematic disturbance.