Prevalence of Symptoms and Symptom-based Conditions among Gulf War Veterans: Current Status of Research Findings

Barrett, Drue H.

doi:10.1093/epirev/mxf003

Cited by 79 publications

(75 citation statements)

References 57 publications

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“…In a study of military personnel, Barrett et al (2002) noted that the primary cause of reported physical health decline in military trauma victims is via PTSD, because PTSD fosters both increased reporting of physical health symptoms and direct triggering of physical health declines, including neurologic, gastrointestinal, and musculoskeletal complaints. Schnurr and Spiro (1999) also found in analysis of the VA's Normative Aging Study data that PTSD symptoms longitudinally predicted poor physical health status.…”

Section: Interrelated Mental and Physical Healthmentioning

confidence: 99%

Combat exposure and mental health: the long-term effects among US Vietnam and Gulf war veterans

Gade

Wenger

2011

Health Econ.

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Using a random sample of more than 4000 veterans, we test the effects of combat exposure on mental health. We focus on two cohorts of veterans: those who served in Vietnam (1964-1975) and the Gulf War (1990-1991). Combat exposure differed between these groups in intensity, duration and elapsed time since exposure. We find that combat exposure generally, and exposure to dead, dying, or wounded people, specifically, is a significant predictor of mental health declines as measured by an individual's Mental Component Summary score. Under our general specifications, the negative effects of combat on mental health were larger for Gulf war veterans than for Vietnam veterans as of 2001. These effects persist after controlling for demographic characteristics, insurance coverage, income and assets. Using discrete factor, nonparametric maximum likelihood (DFML) estimation we controlled for unobserved heterogeneity as well as the factors above. In the DFML specifications we find a negative impact of exposure to dead, wounded or dying people for both Gulf and Vietnam veterans, but find no statistically significant effect for combat exposure overall for Vietnam veterans as of 2001. Based on our Gulf war parameters, we estimate that the costs of mental health declines to be between $87 and $318 per year for each soldier with combat service and exposure to dead, dying and wounded people.

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Section: Interrelated Mental and Physical Healthmentioning

confidence: 99%

Combat exposure and mental health: the long-term effects among US Vietnam and Gulf war veterans

Gade

Wenger

2011

Health Econ.

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“…Differences in self-reporting of symptoms which have been documented elsewhere (9,11,(13)(14)(15), were not considered in this analysis. In addition, only regular active duty personnel were included as military hospitalization data were only available electronically for these personnel.…”

Section: Resultsmentioning

confidence: 99%

“…Military personnel returning from the 1991 Gulf War have reported a wide range of symptoms including fatigue, cognition problems, and musculoskeletal conditions which some have suggested may be related to service in the Gulf (8)(9)(10)(11)(12)(13)(14)(15). Etiologies for increased symptom reporting remain elusive and epidemiologic studies of 1991 Gulf War veterans have found no increased risk of morbidity among Gulf War veterans as measured by birth defects among live births in active duty members within 2 years of the Gulf War (16), hospitalizations in active duty members within 2 years of the Gulf War (17), hospitalizations among members who did not seek care at Department of Defense (DoD) treatment facilities (18), hospitalizations for select diagnoses (19), or mortality due to diseases (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the Post-Deployment Hospitalization Experience of US Military Personnel Following Service in the 1991 Gulf War, Southwest Asia After the Gulf War, and Bosnia

Smith¹,

Smith²,

Ryan³

et al. 2004

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Much attention has been given to the impact of deployment upon the health of veterans from the first Gulf War. While differences in self-reported symptoms have been common, no specific exposures have been implicated. Some have suggested that stress from deployment is the chief cause for multi-symptom conditions among 1991 Gulf War veterans. We sought to examine the impact of large military deployments upon hospitalization experience.Hospitalization records from October 1, 1988 through December 31, 2000 were examined for all active duty personnel deployed exclusively to the Gulf War, Southwest Asia, or Bosnia. Cox's hazard modeling was used to model time until first post-deployment hospitalization, separation from active duty, or December 31, 2000, whichever occurred first, while controlling for influential covariates and temporal changes. As compared to Gulf War veterans (n=455,465), personnel deployed to Southwest Asia after the Gulf War (n=249,047) were at a slight increased risk of hospitalization (HR=1.05; 95% CI =1.02, 1.08). However, personnel deployed to Bosnia (n=44,341) were at decreased risk for any-cause hospitalization (HR=0.69; 95% CI =0.66, 0.72).While these findings do not fully explain the complexity of post-deployment health experiences, they do not support the theory of a unique illness in 1991 Gulf War veterans.2

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“…This high percentage is unsurprising in comparison to studies related to the Gulf War experience. [2][3][4] If our results were extrapolated to the whole of the British Armed Forces, between 45,000 and 60,000 servicemen would be referred to a medical centre in the first cycle of the screening programme. This would have a serious repercussion for the readiness and preparedness of the Services, and medical resource implications.…”

Section: Discussionmentioning

confidence: 99%

Screening for physical and psychological illness in the British Armed Forces: I: The acceptability of the programme

et al. 2004

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Objectives:To assess the response to a self-administered questionnaire and attendance of a medical centre for physical and psychological health screening.Methods: 4500 men and women from the three services were randomly selected to receive either a full or abridged screening questionnaire. The full questionnaire included the General Health Questionnaire-12 (GHQ-12) and Post-traumatic Stress Disorder (PTSD) checklist, 15 symptoms, a selfassessed health status question and three questions on alcohol behaviour (WHO Audit). The abridged questionnaire included GHQ-4, a slightly shortened PTSD checklist and five symptoms, but excluded questions on alcohol behaviour. All 'screen-positive' and a random 'screen-negative' sample were invited to attend a medical centre.Results: 67.1% of the servicemen completed a questionnaire; slightly but significantly more the abridged than the full questionnaire (4.9%, 95% confidence interval 2.3-7.4%). Of those receiving a full or abridged questionnaire, 32% and 22.5% respectively were 'screen-positives', most of the difference (7.5%) attributable to alcohol behaviour. Less than 30% of the servicemen invited to attend a medical centre accepted the invitation, even fewer during the preparation for deployment to Iraq. Those who fulfilled the criteria for PTSD, alcohol behaviour or multi-criteria 'screen-positive' were more reluctant than controls to attend. Conclusions:Screening for psychological illness has little support among servicemen, perhaps because they may not wish to share concerns with a military doctor. Avoidance behaviour among those with a psychological condition may also selectively reduce willingness to attend a medical centre. Screening during pre-deployment periods has even less support than at other times.

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Prevalence of Symptoms and Symptom-based Conditions among Gulf War Veterans: Current Status of Research Findings

Cited by 79 publications

References 57 publications

Combat exposure and mental health: the long-term effects among US Vietnam and Gulf war veterans

Combat exposure and mental health: the long-term effects among US Vietnam and Gulf war veterans

A Comparison of the Post-Deployment Hospitalization Experience of US Military Personnel Following Service in the 1991 Gulf War, Southwest Asia After the Gulf War, and Bosnia

Screening for physical and psychological illness in the British Armed Forces: I: The acceptability of the programme

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