Chronic multisymptom illness complex in Gulf War I veterans 10 years later

被引:102
作者
Blanchard, MS
Eisen, SA
Alpern, R
Karlinsky, J
Toomey, R
Reda, DJ
Murphy, FM
Jackson, LW
Kang, HK
机构
[1] St Louis Vet Affairs Med Ctr, Med Serv, St Louis, MO 63106 USA
[2] St Louis Vet Affairs Med Ctr, Res Serv, St Louis, MO 63106 USA
[3] Washington Univ, Sch Med, Dept Internal Med, St Louis, MO 63110 USA
[4] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Cooperat Studies Program Coordinating Ctr, Hines, IL 60141 USA
[5] VA Boston Healthcare Syst, Boston, MA USA
[6] Boston Univ, Sch Med, Dept Med, Div Pulm & Crit Care Med, W Roxbury, MA USA
[7] Harvard Univ, Sch Med, Dept Psychiat, Massachusetts Mental Hlth Ctr, Boston, MA 02115 USA
[8] Harvard Univ, Sch Publ Hlth, Inst Psychiat Epidemiol & Genet, Boston, MA 02115 USA
[9] Harvard Univ, Sch Med, Boston, MA 02115 USA
[10] Dept Vet Affairs, Cent Off, Washington, DC USA
[11] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA
[12] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA
[13] Dept Vet Affairs, Environm Epidemiol Serv, Washington, DC USA
[14] George Washington Univ, Sch Publ Hlth & Hlth Serv, Washington, DC USA
关键词
Gulf War; metabolic syndrome X; Persian Gulf syndrome; quality of life; risk factors; stress; psychological; veterans;
D O I
10.1093/aje/kwj008
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Prior research has demonstrated that shortly after the 1991 Gulf War (Gulf War I), chronic multisymptom illness (CMI) was more common among deployed veterans than among nondeployed veterans. The aims of the current study were to determine the prevalence of CMI among deployed and nondeployed veterans 10 years after Gulf War I, compare the distribution of comorbid conditions, and identify prewar factors associated with CMI. Cross-sectional data collected from 1,061 deployed veterans and 1,128 nondeployed veterans examined between 1999 and 2001 were analyzed. CMI prevalence was 28.9% among deployed veterans and 15.8% among nondeployed veterans (odds ratio = 2.16, 95% confidence interval: 1.61, 2.90). Deployed and nondeployed veterans with CMI had similarly poorer quality-of-life measures and higher prevalences of symptom-based medical conditions, metabolic syndrome, and psychiatric disorders. Diagnoses of prewar anxiety disorders (not related to post-traumatic stress disorder) and depression were associated with CMI among both deployed and nondeployed veterans. Nicotine dependence and veteran-reported physician-diagnosed infectious mononucleosis were associated with CMI among deployed veterans, and migraine headaches and gastritis were associated with CMI among nondeployed veterans. CMI continues to be substantially more prevalent among deployed veterans than among nondeployed veterans 10 years after Gulf War I, but it manifests similarly in both groups. It is likely to be a common, persistent problem among veterans returning from the current Gulf War.
引用
收藏
页码:66 / 75
页数:10
相关论文
共 47 条
[1]   A review of the evidence for overlap among unexplained clinical conditions [J].
Aaron, LA ;
Buchwald, D .
ANNALS OF INTERNAL MEDICINE, 2001, 134 (09) :868-881
[2]   Evaluation of neuromuscular symptoms in veterans of the Persian Gulf War [J].
Amato, AA ;
McVey, A ;
Cha, C ;
Matthews, EC ;
Jackson, CE ;
Kleingunther, R ;
Worley, L ;
Cornman, E ;
KaganHallet, K .
NEUROLOGY, 1997, 48 (01) :4-12
[3]   The psychometric properties of the composite international diagnostic interview [J].
Andrews, G ;
Peters, L .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 1998, 33 (02) :80-88
[4]  
[Anonymous], 1995, Arch Intern Med, V155, P262
[5]   Diagnostic status and treatment recommendations for Persian Gulf war veterans with multiple nonspecific symptoms [J].
Baker, DG ;
McQuarrie, IG ;
Murray, MG ;
Lund, LM ;
Dashevsky, BA ;
Mendenhall, CL .
MILITARY MEDICINE, 2001, 166 (11) :972-981
[6]  
Bjorntorp P, 2001, Obes Rev, V2, P73, DOI 10.1046/j.1467-789x.2001.00027.x
[7]   Relationship between stress and pain in work-related upper extremity disorders: The hidden role of Chronic Multisymptom Illnesses [J].
Clauw, DJ ;
Williams, DA .
AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, 2002, 41 (05) :370-382
[8]   Clinical findings for the first 1000 Gulf war veterans in the Ministry of Defence's medical assessment programme [J].
Coker, WJ ;
Bhatt, BM ;
Blatchley, NF ;
Graham, JT .
BMJ-BRITISH MEDICAL JOURNAL, 1999, 318 (7179) :290-296
[9]   Clinical and laboratory assessment of distal peripheral nerves in Gulf War veterans and spouses [J].
Davis, LE ;
Eisen, SA ;
Murphy, FM ;
Alpern, R ;
Parks, BJ ;
Blanchard, M ;
Reda, DJ ;
King, MK ;
Mithen, FA ;
Kang, HK .
NEUROLOGY, 2004, 63 (06) :1070-1077
[10]   Benefits and harms of doxycycline treatment for Gulf War veterans' illnesses [J].
Donta, ST ;
Engel, CC ;
Collins, JF ;
Baseman, JB ;
Dever, LL ;
Taylor, T ;
Boardman, KD ;
Kazis, LE ;
Martin, SE ;
Horney, RA ;
Wiseman, AL ;
Kernodle, DS ;
Smith, RP ;
Baltch, AL ;
Handanos, C ;
Catto, B ;
Montalvo, L ;
Everson, M ;
Blackburn, W ;
Thakore, M ;
Brown, ST ;
Lutwick, L ;
Norwood, D ;
Bernstein, J ;
Bacheller, C ;
Ribner, B ;
Church, LWP ;
Wilson, KH ;
Guduru, P ;
Cooper, R ;
Lentino, J ;
Hamill, RJ ;
Gorin, AB ;
Gordan, V ;
Wagner, D ;
Robinson, C ;
DeJace, P ;
Greenfield, R ;
Beck, L ;
Bittner, M ;
Schumacher, HR ;
Silverblatt, F ;
Schmitt, J ;
Wong, E ;
Ryan, MAK ;
Figueroa, J ;
Nice, C ;
Feussner, JR .
ANNALS OF INTERNAL MEDICINE, 2004, 141 (02) :85-94