Thursday, March 7, 2013

The Environment and Mental Health

The Environment and Mental Health: A Guide for Clinicians
edited by Ante Lundberg; Mahwah, New Jersey, Lawrence Erlbaum Associates, 1998, 233 pages, $59.95

Timothy Lacy, M.D.


Environmental illness is a concept of growing concern to all health professionals. Patients with problems presumably caused by sick buildings, electromagnetic fields and hypersensitivity to chemicals--to name a few--are often referred to psychologists, psychiatrists, and other counselors. The battery worker with fatigue, headaches, abdominal pain and an elevated lead level ...the assembly worker with pain and numbness in her hand and delayed median nerve conduction ...the patient who develops typical ...

In his introduction to this text, editor Lundberg states that the book "is designed to introduce the new field of environmental psychiatry, to illustrate its importance for clinical practice, and to serve as a practical guide."

This is impressive, given that environmental psychiatry is currently undefined. The editor includes an interestingly broad range of topics such as behavioral neurotoxicity, psychological response to trauma and disaster, risk perception and coping environmental illness, the effects of the environment on mental health, nature and mental health, pet therapy, and ecopsychology.

The reader is justified to ask whether environmental psychiatry is, in fact, a new field with a unified body of knowledge, or merely a collection of varied topics that share common themes with the environment.

This text is extremely well referenced throughout and has a useful index. The appendix contains a list of informative Web sites and toll-free telephone numbers where one can find useful environmental data.

It is at its best when exploring the controversial syndromes that often frustrate clinicians. The contributors offer a balanced approach and consider all relevant data that are both supportive and unsupportive of so-called environmental illnesses—even though the difference between environmental illness and neurotoxin exposure remains unclear throughout the text.

Consider for example “…We know that exposure to lead, mercury, and PCBs affect psychological development and behavior; we know much less about the effects of thousands of other chemicals in the environment. In addition, global climate change, social disruption, and the spread of infections will--in the near future--expose people to novel environmental threats. Symptoms caused by toxins can overlap those caused by fear, stress, and depression, and the clinical picture can mimic a variety of other mental disorders.

On the other hand, the natural environment can also be a healer. Research shows that hospital stays are shortened and the need for pain medication reduced for patients exposed to nature, even in images, or to the company of animals. Nursing home patients live longer if allowed to keep pets, and one controlled study shows that caring for animals reduces disruptive behavior in even the most difficult ADD children...”

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