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Mental health of US Gulf War veterans 10 years after the war

Research Service, Boston Veterans Affairs (VA) Healthcare System, Brockton, Massachusetts, Massachusetts Mental Health Center Public Academic Psychiatry Division of the Beth Israel Deaconess Medical Center Department of Psychiatry, Harvard Medical School Department of Psychiatry, Harvard Institute of Psychiatric Epidemiology and Genetics and Psychology Department, Boston University, Boston, Massachusetts

Han K. Kang, DrPH

Environmental Epidemiology Service, Department of Veterans Affairs, Washington, DC

Joel Karlinsky, MD, MBA

Veterans Affairs Medical Center, Boston and Department of Medicine, Division of Pulmonary and Critical Care Medicine, Boston University School of Medicine, West Roxbury, Massachusetts

Dewleen G. Baker, MD

Psychiatry Service, VA San Diego Health Care System and University of California, San Diego, California

Jennifer J. Vasterling, PhD

VA South Central (VISN 16) Mental Illness Research, Education and Clinical Center, New Orleans Veterans Affairs Medical Center and Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, Louisiana

Renee Alpern, MS and Domenic J. Reda, PhD

Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Hospital, Hines, Illinois

William G. Henderson, PhD

University of Colorado Health Outcomes Program and Department of Preventive Medicine and Biometrics, Aurora, Colorado

Frances M. Murphy, MD

Veterans Health Administration, Department of Veterans Affairs, and Uniformed Services for the Health Sciences, Washington, DC

Seth A. Eisen, MD, MSc

Medical and Research Services, St Louis Department of Veterans Affairs Medical Center and Department of Internal Medicine, Division of General Medical Sciences, Washington University School of Medicine, St Louis, Missouri, USA

Correspondence: Dr Rosemary Toomey, Toomey, Psychology Department, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215, USA. Tel: +1 617 358 3048; fax: +1 617 358 1380; email: rosemary_toomey{at}hms.harvard.edu

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Gulf War veterans reported multiple psychological symptoms immediately after the war; the temporal course of these symptoms remains unclear.

Aims To assess the prevalence of warera onset mental disorders in US veterans deployed to the Gulf War and in non-deployed veterans 10 years after the war.

Method Mental disorders were diagnosed using structured clinical interviews. Standard questionnaires assessed symptoms and quality of life.

Results Gulf War-era onset mental disorders were more prevalent in deployed veterans (18.1%, n=1061) compared with non-deployed veterans (8.9%, n=1128). The prevalence of depression and anxiety declined 10 years later in both groups, but remained higher in the deployed group, who also reported more symptoms and a lower quality of life than the non-deployed group. Remission of depression may be related to the presence of comorbid psychiatric disorders and level of education. Remission of anxiety was related to treatment with medication.

Conclusions Gulf War deployment was associated with an increased prevalence of mental disorders, psychological symptoms and a lower quality of life beginning during the war and persisting at a lower rate 10 years later.

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