Sick Building Syndrome (SBS), Personality, Psychosocial Factors and Treatment

  • Roma Runeson-BrobergEmail author
Part of the Current Topics in Environmental Health and Preventive Medicine book series (CTEHPM)


It is well known that patients seek help for symptoms attributed to the exposure of different indoor environments. Due to lack of knowledge about these symptoms, patients were often treated as hysterics. In the early 1980s, the sick building syndrome (SBS) concept was defined by the World Health Organization (WHO). SBS symptoms were reported to be in the eyes, nose, throat, and lower airways; skin reactions; non-specific hypersensitivity; mental fatigue; headaches; nausea and dizziness among persons staying in the suspected building. The SBS symptoms in most cases disappeared or diminished after leaving the building. Some patients though stayed sensitive and had the SBS symptoms even after leaving the suspected building. They also with time became sensitive to other exposures such as smells, perfumes, electromagnetic fields and suffered from anxiety symptoms. In such cases it is an environmental illness (EI) of psychogenic nature that can be treated therapeutically. Personality studies show that on a group level the SBS subjects have personality traits within normal range and not on a pathological level, although they have personality traits such as high anxiety, high aggressivity, low sense of coherence, and higher neuroticism which created a vulnerability factor for SBS. Psychosocial studies show that poor psychological work environment is associated to SBS symptoms. Follow-up studies of SBS patients reveal that they were not treated and that their symptoms worsened with time. There are no studies on effective treatment methods for SBS patients, although psychological methods for treatment of similar problems exist, such as anxiety and phobia disorders. One such a method is Cognitive Behavioral Therapy (CBT) with a focus on identifying factors that maintain the expression of anxiety. However, there are unpublished clinical reports that CBT alone is not enough in treating the SBS patients successfully. The therapists reported a struggle with the patient’s own needs to project the cause of illness onto the physical environment and the EI patients complained that the therapists were lacking a broader knowledge in the field of environmental medicine and were not able to alleviate the patients’ worries. In order to handle therapy pitfalls, an Integrative Model for treatment of Environmental Illness of psychogenic nature (IMEI) was developed. The focus of this model is uncovering and treating the environmental sensitivity of a psychogenic nature. When the patient understands the process generating the symptoms, identifies anxiety and hyperventilation as a cause of the symptoms, and acquires skills to prevent the symptoms, then resistance develops to the thoughts and worries about the catastrophic symptoms that previously were disabling. The IMEI can be successfully applied with any environmental sensitivity of psychogenic nature provided that the patients are motivated to discover the role of psychological factors involved in generating the symptoms.


SBS Environmental illness Personality Psychosocial factors Treatment CBT Integrative model for treatment of EI IMEI 



Cognitive behavioral therapy


The Cornell index-form N3


The stress and crisis inventory


The job demands control support model


The Eysenck’s personality inventory


The hospital anxiety and depression scale


The integrative model for treatment of environmental illness


The Karolinska scales of personality


The multiple chemical sensitivity


The mental fatigue scale


The Minnesota multiphasic personality inventory


The sick building syndrome


The sick house syndrome


The stress load


The sense of coherence


The Toronto alexithymia scale


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Occupational and Environmental Medicine, Department of Medical SciencesUppsala UniversityUppsalaSweden

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