The Environment and Mental Health: A Guide for Clinicians

By Ante Lundberg | Go to book overview

remove the individual from the source. This is not a simple task, when livelihood or home is involved. Next, other risk factors such as smoking, alcohol, and medications should be reduced as much as possible. Behavior therapy and biofeedback have been shown effective for reduction of anxiety ( Hartman, 1995). The therapist should also explore the meaning of the illness for the patient and assess his personal resources and coping style in order to help him deal with feelings of helplessness, victimization, grief, and fear.

At times, the clinician may need to be willing to work with a patient who is also pursuing other, nontraditional health initiatives. Many patients, especially those who may have been made ill by environmental sensitivity and exposure, are dissatisfied with traditional medical care. Their forays into alternative medicine are attempts at self-help and self-care. It behooves clinicians to be open-minded supportive of the patient's efforts.

Patients with significant neuropsychological deficits need to be monitored by a team including a neuropsychologist and other specialists and they must be offered rehabilitation aiming to train compensatory functions. Those with subtle neuropsychological findings should be followed with repeated evaluations, 12 to 24 months apart, to determine the course of progression. The limited data available suggest that subtle deficits can improve after exposure ceases.


REFERENCES

Agnew J., & Masten V. L. ( 1994). Neuropsychological assessment of occupational neurotoxic exposure. In M. L. Bleecker & J. A. Hansen (Eds.), Occupational neurolop and clinical neurotoxicolop (pp. 113-160). Baltimore: Williams & Wilkins.

American Psychiatric Association. ( 1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Bleecker M. L., & Hansen J. A. (Eds.). ( 1994). Occuptional, neurolog anti clinical neurotoxicology Baltimore: Williams & Wilkins.

Crum R. M., Anthony J. C., Bassett S. S., & Folstein M. F. ( 1993). "Population-based norms for the Mini-Mental Status Examination by age and education level". JAMA, 269, 2386-2391.

Donoghue A. M., Dryson E. V., & Wynn-Williams G. ( 1995). "Contrast sensitivity in organicsolvent-induced chronic toxic encephalopathy". Journal of Occupational and Environmental Medicine, 37, 1357- 1363.

Folstein M. F., Folstein S. E., & McHugh P. R. ( 1975). "Mini-mental state: A practical method for grading the cognitive state of patients for the clinician". Journal of Psychiatric Research, 12, 189-198.

Hartman D. E. ( 1995). Neuropsychological toxicology (2nd ed.). New York: Plenum Press.

Letz R., & Baker E. L. ( 1988). NES2 Neurobehavioral Evaluation System. Winchester, MA: Neurobehavioral Evaluation Systems.

Lezak M. D. ( 1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.

Mazure C. M. (Ed.). ( 1995). Does strevs cauve psychiatric illness. Washington, DC: American Psychiatric Press.

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