PSYCHOGENIC REACTIONS TO FOOD ARE IMPORTANT IN THE DIAGNOSIS OF FOOD ALLERGY AND INTOLERANCE
Occasionally people develop psychogenic reactions to food when there is no physical response. This can happen if someone becomes convinced that they are food-allergic or food-intolerant without undergoing proper diagnosis. They may decide that they react to particular foods, on the basis of a bogus diagnostic test or an elimination diet that is not properly carried out. Thereafter the reaction occurs obligingly every time they eat the food – but the response is a psychogenic one. This response is one of the pitfalls of self-treatment, but it can occur just as readily – if not more so – with treatment by fringe practitioners who use ineffective methods of diagnosis.
Psychogenic reactions of this type are most likely to occur in those whose symptoms are purely psychosomatic, but who prefer to think they are ‘allergic’ to food, because they see this as being a more respectable sort of illness. The medical neglect of psychosomatic illness and hypochondria must shoulder some of the blame in such situations, because the stigma attached to these disorders owes much to doctors’ negative attitudes.
Patients who mistakenly believe that they are sensitive to food often put themselves on increasingly strict diets as their symptoms persist, and they may become seriously malnourished. They are in need of sympathetic professional help to identify the true causes of their malaise, and should be persuaded to undertake psychotherapy or some other form of psychological treatment. Such treatment can be valuable even where foods are a major cause of symptoms, so undertaking this type of therapy is worthwhile for a whole range of patients, not just for those whose problems are purely psychosomatic.
Psychogenic reactions to food are important in the diagnosis of food allergy and intolerance, because a challenge with any food may produce symptoms if the patient is expecting symptoms. In order to separate real responses from psychogenic ones, dummy challenges, with foods that are known not to cause any reaction, are included in the double-blind trials. Most patients are expected to respond to some of these dummy challenges, but they should respond to significantly more of the real ones. These dummy challenges are also known as placebos.
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