Adverse reactions to foods: relevance to psychiatric disorders

There is some evidence in the literature that adverse reactions to foods can contribute to behavioral dysfunction. In view of what is known about food and behavior, this suggestion is entirely plausible. However, clear demonstrations of adverse behavioral reactions to foods have not been reported. The major methodologic problems are those of defining suitable baseline conditions and dealing with large ranges in dose, time course, and severity of reactions among putatively food-sensitive individuals. These problems, although large, are surmountable. Another problem for studies in this area is nomenclature. The imprecision with which terms are used undoubtedly will diminish as the various mechanisms by which food can affect individuals are delineated. Until these issues are clarified, we are confronted with a group of patients who are convinced that their symptoms are somehow related to the food that they eat. Some basic guidelines may help in the initial screening of these patients. If a history of behavioral dysfunction related to food intolerance occurs in the context of other signs of allergy or hypersensitivity, it seems prudent to evaluate and treat the allergic or hypersensitivity condition and note the effect of that treatment on behavior. If the food complaints occur in the context of marked suggestibility and large numbers of unexplained complaints are registered without any evidence of allergy or hypersensitivity, a diagnosis of somatization disorder should be entertained. If food complaints occur in a patient who does not meet the criteria for somatization disorder, a working diagnosis of undiagnosed medical condition should be entertained.(ABSTRACT TRUNCATED AT 250 WORDS)