Am J Epidemiol 2003; 157:141-148.
Copyright © 2003 by Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Post-Traumatic Stress Disorder and Chronic Fatigue Syndrome-like Illness among Gulf War Veterans: A Population-based Survey of 30,000 Veterans
1 Veterans Health Administration, Department of Veterans Affairs, Washington, DC.
2 Veterans Health Administration, Department of Veterans Affairs, East Orange, NJ.
3 Food and Drug Administration, Department of Health and Human Services, Rockville, MD.
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.
fatigue syndrome, chronic; Persian Gulf syndrome; stress disorders, post-traumatic; veterans
Abbreviations: Abbreviations: CFS, chronic fatigue syndrome; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised; PTSD, post-traumatic stress disorder.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. A LeardMann, T. C Smith, B. Smith, T. S Wells, M. A K Ryan, and for the Millennium Cohort Study Team Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study BMJ, April 16, 2009; 338(apr16_2): b1273 - b1273. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Ouimette, D. Coolhart, D. Sugarman, J. S. Funderburk, R. H. Zelman, and C. Dornau A Pilot Study of Posttraumatic Stress and Associated Functioning of Army National Guard Following Exposure to Iraq Warzone Trauma Traumatology, September 1, 2008; 14(3): 51 - 56. [Abstract] [PDF]
|
|
|
|
 |
|
 A. I. Schneiderman, E. R. Braver, and H. K. Kang Understanding Sequelae of Injury Mechanisms and Mild Traumatic Brain Injury Incurred during the Conflicts in Iraq and Afghanistan: Persistent Postconcussive Symptoms and Posttraumatic Stress Disorder Am. J. Epidemiol., June 15, 2008; 167(12): 1446 - 1452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. E. Larson, R. M. Highfill-McRoy, and S. Booth-Kewley Psychiatric Diagnoses in Historic and Contemporary Military Cohorts: Combat Deployment and the Healthy Warrior Effect Am. J. Epidemiol., June 1, 2008; 167(11): 1269 - 1276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Ciccone, L. Weissman, and B. H. Natelson Chronic Fatigue Syndrome in Male Gulf War Veterans and Civilians: A Further Test of the Single Syndrome Hypothesis J Health Psychol, May 1, 2008; 13(4): 529 - 536. [Abstract] [PDF]
|
|
|
|
 |
|
 K. H. Seal, D. Bertenthal, S. Maguen, K. Gima, A. Chu, and C. R. Marmar Getting Beyond "Don't Ask; Don't Tell": an Evaluation of US Veterans Administration Postdeployment Mental Health Screening of Veterans Returning From Iraq and Afghanistan Am J Public Health, April 1, 2008; 98(4): 714 - 720. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C Smith, M. A K Ryan, D. L Wingard, D. J Slymen, J. F Sallis, D. Kritz-Silverstein, and for the Millennium Cohort Study Team New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study BMJ, February 16, 2008; 336(7640): 366 - 371. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Hoge, D. McGurk, J. L. Thomas, A. L. Cox, C. C. Engel, and C. A. Castro Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq N. Engl. J. Med., January 31, 2008; 358(5): 453 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Seal, D. Bertenthal, C. R. Miner, S. Sen, and C. Marmar Bringing the War Back Home: Mental Health Disorders Among 103 788 US Veterans Returning From Iraq and Afghanistan Seen at Department of Veterans Affairs Facilities Arch Intern Med, March 12, 2007; 167(5): 476 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Hoge, A. Terhakopian, C. A. Castro, S. C. Messer, and C. C. Engel Association of Posttraumatic Stress Disorder With Somatic Symptoms, Health Care Visits, and Absenteeism Among Iraq War Veterans Am J Psychiatry, January 1, 2007; 164(1): 150 - 153. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Heim, D. Wagner, E. Maloney, D. A. Papanicolaou, L. Solomon, J. F. Jones, E. R. Unger, and W. C. Reeves Early Adverse Experience and Risk for Chronic Fatigue Syndrome: Results From a Population-Based Study. Arch Gen Psychiatry, November 1, 2006; 63(11): 1258 - 1266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Grieger, S. J. Cozza, R. J. Ursano, C. Hoge, P. E. Martinez, C. C. Engel, and H. J. Wain Posttraumatic Stress Disorder and Depression in Battle-Injured Soldiers Am J Psychiatry, October 1, 2006; 163(10): 1777 - 1783. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Lucas, H. K. Armenian, G. M. Petersen, and P. C. Rowe Familial aggregation of fainting in a case-control study of neurally mediated hypotension patients who present with unexplained chronic fatigue Europace, October 1, 2006; 8(10): 846 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Hunt, M. Jakupcak, M. McFall, M. Orsborn, B. Felker, S. Larson, and M. Klevens RE: "CHRONIC MULTISYMPTOM ILLNESS COMPLEX IN GULF WAR I VETERANS 10 YEARS LATER" Am. J. Epidemiol., October 1, 2006; 164(7): 708 - 709. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Jones, R. J. Rona, R. Hooper, and S. Wesseley The burden of psychological symptoms in UK Armed Forces Occup. Med., August 1, 2006; 56(5): 322 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Ismail and G. Lewis Multi-symptom illnesses, unexplained illness and Gulf War Syndrome Phil Trans R Soc B, April 29, 2006; 361(1468): 543 - 551. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. C Gray and H. K Kang Healthcare utilization and mortality among veterans of the Gulf War Phil Trans R Soc B, April 29, 2006; 361(1468): 553 - 569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Brown Toxicological assessments of Gulf War veterans Phil Trans R Soc B, April 29, 2006; 361(1468): 649 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Hoge, J. L. Auchterlonie, and C. S. Milliken Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan JAMA, March 1, 2006; 295(9): 1023 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Eisen, H. K. Kang, F. M. Murphy, M. S. Blanchard, D. J. Reda, W. G. Henderson, R. Toomey, L. W. Jackson, R. Alpern, B. J. Parks, et al. Gulf War Veterans' Health: Medical Evaluation of a U.S. Cohort Ann Intern Med, June 7, 2005; 142(11): 881 - 890. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Friedman Veterans' Mental Health in the Wake of War N. Engl. J. Med., March 31, 2005; 352(13): 1287 - 1290. [Full Text] [PDF]
|
|
|
|
|
|
H. K. Kang and K. C. Hyams Mental Health Care Needs among Recent War Veterans N. Engl. J. Med., March 31, 2005; 352(13): 1289 - 1289. [Full Text] [PDF]
|
|
|
|
 |
|
 H L Kelsall, M R Sim, A B Forbes, D C Glass, D P McKenzie, J F Ikin, M J Abramson, L Blizzard, and P Ittak Symptoms and medical conditions in Australian veterans of the 1991 Gulf War: relation to immunisations and other Gulf War exposures Occup. Environ. Med., December 1, 2004; 61(12): 1006 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Heim, C. Bierl, R. Nisenbaum, D. Wagner, and W. C. Reeves Regional Prevalence of Fatiguing Illnesses in the United States Before and After the Terrorist Attacks of September 11, 2001 Psychosom Med, September 1, 2004; 66(5): 672 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Carter-Pokras, C. R. Baquet, and C. F. Poppell RE: "FOUR-YEAR REVIEW OF THE USE OF RACE AND ETHNICITY IN EPIDEMIOLOGIC AND PUBLIC HEALTH RESEARCH" Am. J. Epidemiol., August 15, 2004; 160(4): 403 - 404. [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. IKIN, M. R. SIM, M. C. CREAMER, A. B. FORBES, D. P. McKENZIE, H. L. KELSALL, D. C. GLASS, A. C. McFARLANE, M. J. ABRAMSON, P. ITTAK, et al. War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War The British Journal of Psychiatry, August 1, 2004; 185(2): 116 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Hoge, C. A. Castro, S. C. Messer, D. McGurk, D. I. Cotting, and R. L. Koffman Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care N. Engl. J. Med., July 1, 2004; 351(1): 13 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Friedman Acknowledging the Psychiatric Cost of War N. Engl. J. Med., July 1, 2004; 351(1): 75 - 77. [Full Text] [PDF]
|
|
|
|
|
|
G. Lawrenson and J. Ogden Security duties in Northern Ireland and the mental health of soldiers: prospective study BMJ, December 13, 2003; 327(7428): 1382 - 1382. [Full Text] [PDF]
|
|