http://www.psychosomaticmedicine.org/cgi/content/abstract/63/5/842
|
Psychosomatic
Medicine 63:842-849 (2001)
© 2001 American
Psychosomatic Society
ORIGINAL ARTICLES
|
Posttraumatic Stress Symptomatology Is Associated With Unexplained Illness
Attributed to Persian Gulf War Military Service
University of Connecticut School of Medicine
(J.D.F.), Farmington, Connecticut; Department of Veterans Affairs Environmental
Hazards Research Center Medical Center and Oregon Health Sciences University
Departments of Psychiatry (K.A.C., D.S., L.M.B.), and the Oregon Health
Sciences University Center for Research on Occupational and Environmental
Toxicology (W.K.A., D.S.R.), Portland, Oregon.
Correspondence: Address reprint requests to:
Julian D. Ford, University of Connecticut School of Medicine, Department of
Psychiatry, MC1410, 263 Farmington Ave., Farmington CT 06030. Email: Ford@Psychiatry.UCHC.edu
OBJECTIVE: Controversy exists concerning unexplained illness
in Persian Gulf War veterans, especially regarding the contribution of
psychological trauma. We sought to determine if war zone trauma or
posttraumatic stress symptomatology (PTSS) are associated with
illnesses reported by Gulf War veterans that were documented by
medical examination but not attributable to a medical diagnosis.
METHODS: A total of 1119 (55% response rate) of 2022 randomly sampled
veterans of the United States Persian Gulf War were screened and 237
cases and 113 controls were identified by medical examination for a
case-control study comparing Persian Gulf War military veterans with
or without medically documented, but unexplained, symptoms.
Multivariate logistic regression and cross-validation analyses
examined self-report measures of demographics, subjective physical
symptoms and functioning, psychiatric symptoms, stressors, war zone
trauma, and PTSS, to identify correlates of case-control status.
RESULTS: Posttraumatic stress symptomatology and somatic complaints were
independently associated with case status, as were (although less
consistently) war zone trauma and depression. Age, education, and
self-reported health, stress-related somatization, pain, energy/fatigue,
illness-related functional impairment, recent stressors, and anxiety
were univariate (but not multivariate) correlates of case status.
CONCLUSIONS: PTSS related to war zone trauma warrants additional prospective
research study and attention in clinical screening and assessment as
a potential contributor to the often debilitating physical health
problems experienced by Persian Gulf War veterans.
Key Words: adults • combat exposure • etiology • Gulf War •
posttraumatic stress • somatic symptoms
Abbreviations: PTSS = posttraumatic stress symptomatology •
PTSD = posttraumatic stress disorder • PEHRC = Portland (Oregon) Environmental
Hazards Research Center • SCL-90-R GSI = Symptom Checklist 90-Revised Global
Severity Index • BDI = Beck Depression Inventory • BAI = Beck Anxiety Inventory
• MMPI-2 Hs and Hy = Minnesota Multiphasic Personality Inventory-2
Hypochondriasis and Hysteria subscales • LES-NI = Life Experiences
Scale-Negative Impact • SF-36 = 36-item Short Form Health Survey of the Medical
Outcomes Study • SASSI-2 = Substance Abuse Subtle Screening Inventory-2 • CES-R
= Combat Exposure Scale Revised • Miss-PTSD = Mississippi Scale for PTSD • OR =
odds ratio • CI = confidence interval
Copyright
© 2001 by the American Psychosomatic Society
ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.