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Psychiatric disorder in veterans of the Persian Gulf War of 1991

Systematic review

University of Wales College of Medicine, Cardiff

GLYN LEWIS, FRCPsych

University of Bristol, UK

Correspondence: Professor Glyn Lewis, Cotham House, Cotham Hill, Bristol BS6 6JL, UK. E-mail: glyn.lewis{at}bristol.ac.uk

Declaration of interest Funded by the UK Medical Research Council.

Background Veterans of the Persian Gulf War of 1991 have reported symptoms attributed to their military service.

Aims To review all studies comparing the prevalence of psychiatric disorders in Gulf War veterans and in a comparison group of service personnel not deployed to the Gulf War.

Method Studies of military personnel deployed to the Gulf published between 1990 and 2001 were identified from electronic databases. Reference lists and websites were searched and key researchers were contacted for information. A total of 2296 abstracts and 409 complete articles were reviewed and data were extracted independently by two members of the research team.

Results The prevalence of psychiatric disorder in 20 studies of Gulf War veterans was compared with the prevalence in the comparison group. Prevalence of post-traumatic stress disorder (PTSD) and common mental disorder were higher in the Gulf War veterans. Heterogeneity between studies was significant, but all reported this increased prevalence.

Conclusions Veterans of the Persian Gulf War reported an increased prevalence of PTSD and common mental disorder compared with other active service personnel not deployed to the Gulf. These findings are attributable to the increase in psychologically traumatic events in wartime.

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