Searching for a Gulf War syndrome using cluster analysis.
BACKGROUND
Gulf veterans report medically unexplained symptoms more frequently than non-Gulf veterans did. We examined whether Gulf and non-Gulf veterans could be distinguished by their patterns of symptom reporting.


METHODS
A k-means cluster analysis was applied to 500 randomly sampled veterans from each of three United Kingdom military cohorts of veterans; those deployed to the Gulf conflict between 1990 and 1991; to the Bosnia peacekeeping mission between 1992 and 1997; and military personnel who were in active service but not deployed to the Gulf (Era). Sociodemographic, health variables and scores for ten symptom groups were calculated.


RESULTS
The gap statistic indicated the five-group solution as one that provided a particularly informative description of the structure in the data. Cluster 1 consisted of low scores for all symptom groups. Cluster 2 had veterans with highest symptom scores for musculoskeletal symptoms and high scores for psychiatric symptoms. Cluster 3 had high scores for psychiatric symptoms and marginally elevated scores for the remaining nine groups symptom groups. Cluster 4 had elevated scores for musculoskeletal symptoms only and cluster 5 was distinguishable from the other clusters in having high scores in all symptom groups, especially psychiatric and musculoskeletal.


CONCLUSIONS
The findings do not support the existence of a unique syndrome affecting a subgroup of Gulf veterans but emphasize the excess of non-specific self-reported ill health in this group.
Everitt
B
B
Department of Biostatistics, Institute of Psychiatry, Guy's, King's and St Thomas' School of Medicine, London.
Ismail
K
K
David
A S
AS
Wessely
S
S
D017522:Bosnia and Herzegovina; D016000:Cluster Analysis; D015986:Confounding Factors, Epidemiologic; D006801:Humans; D008877:Middle East; D008889:Military Personnel; D009483:Neuropsychological Tests; D018923:Persian Gulf Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D014857:Warfare