Post-traumatic stress disorder and chronic fatigue syndrome-like illness among Gulf War veterans: a population-based survey of 30,000 veterans

Veterans Health Administration, Department of Veterans Affairs, Washington, DC, USA.
American Journal of Epidemiology (Impact Factor: 5.23). 01/2003; 157(2):141-8.
Source: PubMed


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.

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Available from: Clare M Mahan, Oct 10, 2015
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    • "The presence of prolonged severe fatigue is a risk factor for Chronic Fatigue Syndrome (CFS); the prevalence of CFS in US Gulf War Veterans was estimated at 4.9% at approximately 5 years post-deployment (Kang et al., 2003). Studies in both US and Dutch military cohorts have shown that the presence of severe fatigue cannot be explained by PTSD (de Vries et al., 2002; Kang et al., 2003). In addition, we previously showed that 53% of deployed military personnel with severe fatigue six months after return from Afghanistan did not report co-morbid high levels of PTSD or depressive symptoms (van Zuiden et al., 2012). "
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    ABSTRACT: Deployed soldiers are at risk of developing stress-related conditions, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and severe fatigue. We previously observed condition- and cell-specific differences in sensitivity of immune cells for regulation by glucocorticoids (GCs) pre-deployment between male soldiers with and without subsequent development of high levels of these stress-related symptoms. Here we investigated whether these pre-deployment dysregulations in GC-sensitivity of immune cells persisted after return from military deployment.
    Psychoneuroendocrinology 09/2014; 51. DOI:10.1016/j.psyneuen.2014.09.014 · 4.94 Impact Factor
    • "20% for veterans returning from Iraq and Afghanistan) [3]. It is estimated that approximately 8% of the US population suffers from PTSD symptoms at some point during their lifetime [4] and PTSD prevalence is highest in combat veteran populations , ranging from 10% to 30% depending on study and conflict [5] [6]. * Equal contribution, listed alphabetically. "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is an anxiety disorder that affects a large population and that is currently diagnosed mostly through subject interviews and manual analysis of self-reported symptoms and of subject behavior. However, most PTSD cases are believed to go underdiagnosed and un-dertreated. We present a multi-modal system for computer-aided diagnosis of PTSD and stress that requires no clinician interview and relies principally in the elicitation of multimodal neurophysiological responses to audio-visual stimuli. We conduct a thorough evaluation of the discriminative power of the modalities involved (electro encephalography, galvanic skin-response, electrocardiography, head motion and speech), type of stimuli presented (audio, images, audio-and-images and video), and emotions evoked (positive, negative, and trauma-specific) between PTSD subjects and high and low-stress control groups. Our analysis indicates that the multi-modal prediction from the elicitation of trauma-specific emotions from images and audio is a promising approach to computer-aided diagnosis.
    IEEE International Conference on Acoustics, Speech, and Signal Processing (ICASSP 2014), Florence, Italy; 05/2014
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    • "The prevalence of PTSD symptoms before the MVA was evaluated using the 17-item National Center for PTSD Checklist of the Department of Veterans Affairs, the PCL (Blanchard et al. 1996; Kang et al. 2003; Hoge et al. 2004). Symptoms were related to any stressful experience (in the wording of the 'specific stressor' version of the checklist). "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is a chronic and difficult to treat psychiatric disorder. Objective, performance-based diagnostic markers that uniquely index risk for PTSD above and beyond subjective self-report markers could inform attempts to improve prevention and early intervention. We evaluated the predictive value of threat-related attention bias measured immediately after a potentially traumatic event, as a risk marker for PTSD at a 3-month follow-up. We measured the predictive contribution of attentional threat bias above and beyond that of the more established marker of risk for PTSD, self-reported psychological dissociation. Dissociation symptoms and threat-related attention bias were measured in 577 motor vehicle accident (MVA) survivors (mean age = 35.02 years, 356 males) within 24 h of admission to an emergency department (ED) of a large urban hospital. PTSD symptoms were assessed at a 3-month follow-up using the Clinician-Administered PTSD Scale (CAPS). Self-reported dissociation symptoms significantly accounted for 16% of the variance in PTSD at follow-up, and attention bias toward threat significantly accounted for an additional 4% of the variance in PTSD. Threat-related attention bias can be reliably measured in the context of a hospital ED and significantly predicts risk for later PTSD. Possible mechanisms underlying the association between threat bias following a potentially traumatic event and risk for PTSD are discussed. The potential application of an attention bias modification treatment (ABMT) tailored to reduce risk for PTSD is suggested.
    Psychological Medicine 10/2013; 44(10):1-8. DOI:10.1017/S0033291713002456 · 5.94 Impact Factor
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