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Book Forum: The Physiology of Stress   |    
Environmental and Chemical Toxins and Psychiatric Illness
DONALD W. BLACK, M.D.
Am J Psychiatry 2003;160:603-603. doi:10.1176/appi.ajp.160.3.603
View Author and Article Information
Iowa City, Iowa

By James S. Brown, Jr., M.D. Washington, D.C., American Psychiatric Publishing, 2002, 320 pp., $45.00 (paper).

This book fills a needed gap. Although there are texts written for toxicologists and environmental experts, very little is available to psychiatrists on the subjects of toxins. James Brown has assembled an impressive amount of information on known environmental and chemical toxins and presents it in a user-friendly format. For those wanting information on the physical and psychiatric effects of heavy metals such as mercury or lead, pesticides, solvents, and other agents, this book has it all.

Apropos to our post-9/11 world, the book begins with a chapter titled "Military, Terrorists, and Disaster Incidents." Unfortunately, poisoning from these sources has led the world to become an increasingly scary place to live. In order to cope with nearly daily threats, psychiatrists need to have a basic understanding of nerve gas poisoning and other potential threats. Also covered is the so-called Gulf War syndrome, which is handled in a responsible fashion considering all the hysteria that has been attached to the condition. Brown also discusses "sensitivity syndromes," in which I have a substantial interest (1). Although the coverage is brief, it is reasonable and as balanced as something as controversial as this topic can be. This is followed by a discussion of other controversial topics in chapters titled "Food Additives and Child Behavior Disorders" and the "Sick Building Syndrome." Other topics covered in the book include stress reactions, ionizing radiation, toxic gases (including carbon monoxide and hydrogen sulfide), and miscellaneous "elements, chemicals, and syndromes," including such diverse agents as boron, copper, vinyl chloride, and silicon. (Remember the silicon breast implant brouhaha?)

The book also includes useful tables, references, and additional readings. (I guess these are for people who just can’t get enough of the topic.) Brown even divides the additional readings by topic. For example, the additional readings on the multiple chemical sensitivity syndrome are divided by those "generally supportive of the physiologic cause" and "those generally not supportive of a physiologic cause." Most of the references predate 2000, and so the only drawback of this book is that, for many of the conditions discussed (e.g., Gulf War syndrome, multiple chemical sensitivity syndrome), useful papers have been published since the author conducted his literature search. This is a minor drawback. The author should be commended for tackling such a difficult area and producing a readable volume.

Black DW, Doebbeling BN, Voelker MD, Clarke WR, Woolson RF, Barrett DH, Schwartz DA: Multiple chemical sensitivity syndrome—symptom prevalence and risk factors in a military population. Arch Gen Psychiatry  2000; 160:1169-1176
 
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References

Black DW, Doebbeling BN, Voelker MD, Clarke WR, Woolson RF, Barrett DH, Schwartz DA: Multiple chemical sensitivity syndrome—symptom prevalence and risk factors in a military population. Arch Gen Psychiatry  2000; 160:1169-1176
 
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