Post-Traumatic Stress Disorder and Chronic Fatigue Syndrome-like Illness among Gulf War Veterans: A Population-based Survey of 30,000 Veterans

Abstract

The authors estimated the prevalence of post-traumatic stress disorder (PTSD) and illness resembling chronic fatigue syndrome (CFS) in the entire population of Gulf War and non-Gulf-War veterans. They also evaluated the relation between the extent of deployment-related stress and the risk of either PTSD or CFS. In 1995-1997, the authors conducted a health survey in which these two symptom-based medical diagnoses in a population-based sample of 15,000 Gulf War veterans representing four military branches and three unit components (active, reserve, and National Guard) were compared with those of 15,000 non-Gulf veteran controls. Gulf War veterans, compared with non-Gulf veteran controls, reported significantly higher rates of PTSD (adjusted odds ratio = 3.1, 95% confidence interval: 2.7, 3.4) and CFS (adjusted odds ratio = 4.8, 95% confidence interval: 3.9, 5.9). The prevalence of PTSD increased monotonically across six levels of deployment-related stress intensity (test for trend: p < 0.01), while the prevalence of CFS rose only at the low end of the stress spectrum. While deployment-related stress could account for the higher risks of both PTSD and CFS, additional factor(s) unique to the Gulf environment may have contributed to the risk of CFS among Gulf War veterans.

Leukocyte glucocorticoid receptor expression and immunoregulation in veterans with and without post-traumatic stress disorder

“…Epidemiological research increasingly suggests that exposure to traumatic events is related to adverse health outcomes and the onset of specific diseases. 3,4,59 To gain more insight in human adaptation to traumatic stress and the relation of these processes with alterations in GR expression, glucocorticoidimmune interaction and psychopathology, further research in a longitudinal, instead of a cross-sectional design, is preferable.…”

Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study

“…Analysis of individual diagnoses within the broad diagnostic categories of hospitalizations significantly associated with response focused on the five most frequent three-digit diagnostic codes to examine their association with response. Additionally, specific ICD-9-CM diagnoses that have previously been indicative of chronic multisymptom illness were explored [14][15][16][17][18][19][20][21][22][23][24][25]. To further evaluate health care usage differences between responders and nonresponders, the mean number of days spent hospitalized or in outpatient care during the year prior to enrollment was also compared.…”

Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care

“…Research conducted after other military conflicts has shown that deployment stressors and exposure to combat result in considerable risks of mental health problems, including post-traumatic stress disorder (PTSD), major depression, substance abuse, impairment in social functioning and in the ability to work, and the increased use of health care services. [1][2][3][4][5][6][7][8] One study that was conducted just before the military operations in Iraq and Afghanistan began found that at least 6 percent of all U.S. military service members on active duty receive treatment for a mental disorder each year. 9 Given the ongoing military operations in Iraq and Afghanistan, mental disorders are likely to remain an important health care concern among those serving there.…”