War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War.
BACKGROUND
Questions remain about the long-term health impacts of the 1991 Gulf War on its veterans.


OBJECTIVE
To measure psychological disorders in Australian Gulf War veterans and a military comparison group and to explore any association with exposure to Gulf War-related psychological stressors.


METHODS
Prevalences of DSM-IV psychological disorders were measured using the Composite International Diagnostic Interview. Gulf War-related psychological stressors were measured using a service experience questionnaire.


RESULTS
A total of 31% of male Gulf War veterans and 21% of the comparison group met criteria for a DSM-IV disorder first present in the post-Gulf War period. The veterans were at greater risk of developing post-Gulf War anxiety disorders including post-traumatic stress disorder, affective disorders and substance use disorders. The prevalence of such disorders remained elevated a decade after deployment. The findings can be explained partly as a 'war-deployment effect'. There was a strong dose-response relationship between psychological disorders and number of reported Gulf War-related psychological stressors.


CONCLUSIONS
Service in the 1991 Gulf War is associated with increased risk of psychological disorders and these are related to stressful experiences.
Ikin
Jillian F
JF
Monash University, Department of Epidemiology and Preventive Medicine, Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia. jill.ikin@med.monash.edu.au
Sim
Malcolm R
MR
Creamer
Mark C
MC
Forbes
Andrew B
AB
McKenzie
Dean P
DP
Kelsall
Helen L
HL
Glass
Deborah C
DC
McFarlane
Alexander C
AC
Abramson
Michael J
MJ
Ittak
Peter
P
Dwyer
Terry
T
Blizzard
Leigh
L
Delaney
Kerry R
KR
Horsley
Keith W A
KW
Harrex
Warren K
WK
Schwarz
Harry
H
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003130:Combat Disorders / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D018923:Persian Gulf Syndrome / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology*