PSYCHIATRIC ASPECTS OF ALLERGY, By: Richard G. Jaeckle, MD
In 1973, Theron Randolph presented a History of Ecologic Mental Illness in the Annual Review of Allergy. His account started with Savage, an English psychiatrist, who wrote in 1884 of several cases of recurrent attacks of spasmodic asthma alternating with insanity. In the 1890's, three streams of theories developed: behaviorism (Pavlov), psychoanalysis (Freud), and the environment (Hare). Hare’s two-volume treatise in 1905 recorded the effect of foods on behavior. He observed that many chronically ill patients benefited from one of two diets, either avoidance of sugar, starches, and alcohol or the minimization of protein intake. In 1922, Shannon was apparently the first to report that nervousness followed the ingestion of foods, particularly wheat, in infants and children. In 1925, Duke widened the range of allergic symptoms to include headaches to bewilderment, resembling delirium, from foods and simple chemicals. Coca observed that all cases of dementia praecox (schizophrenia) exhibited the typical pulse changes of food allergy, which he had described in 1944. Coca was also the first to note reactions to simple chemicals such as aspirin, gasoline, automotive exhaust, natural gas fumes, perfumes, newsprint, mineral oil and other hydrocarbon exposures. In the 1940's, Randolph observed acute psychotic reactions during food ingestion testing, and reported this in 1950. In fact, he designates the abstract of that year, Allergic Factors in the Etiology of Certain Mental Symptoms, as the first report on the association of commonly eaten foods as incitants and perpetuants of mental illness. In 1961 came Ecologic Mental Illness, describing the levels of CNS reactions and bipolarity (stimulatory or withdrawal). Truss published Tissue Injury Induced by Candida Albicans: Mental and Neurological Manifestations in 1977, extending considerably the notion of causality. In 1957 a Canadian psychiatrist, Hoffer, offered niacin therapy as treatment for Schizophrenia. Another psychiatrist, Philpot, published Brain Allergies: the Psychonutrient Connection in 1980 . He concluded that the majority of over 250 consecutive unselected emotionally disturbed patients developed major symptoms from food and chemicals. The highest percentage occurred in psychotic patients. Werbach published Nutritional Influences of Mental Health in 1991. During the last twenty years, there has been an explosion of technical research on the brain and immune system, which has been dubbed neuroimmunology, psychoneuroendocrinology, or even psychoneuroimmunology. In 1983, Mind and Immunity was published, including over 1300 abstracts from the period 1976 to 1982. The American Psychiatric Association published Depressive Disorders and Immunity in 1989, Psychoimmunology Update in 1991, and Chronic Fatigue and Immune Deficiency Disorders in 1993. All three texts have extensive bibliographies. Some of the subjects include neurotransmitters, receptors, lymphocytes, natural killer cells, T-cells, cytokines, glucocorticoids, mineralocorticoids, neuro peptides, and viruses. On a personal note, I have now practiced Allergy/Environmental Medicine in a psychiatric practice for over ten years. There is no way that I would turn back, since it has been both beneficial to patients and gratifying to me, yielding new insights into the mind-body connection and the doctor-patient relationship. However, I do have grave concerns about the limitations and restrictions placed upon this kind of practice by managed care.