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.
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
Jillian F
JF
Ikin
Malcolm R
MR
Sim
Mark C
MC
Creamer
Andrew B
AB
Forbes
Dean P
DP
McKenzie
Helen L
HL
Kelsall
Deborah C
DC
Glass
Alexander C
AC
McFarlane
Michael J
MJ
Abramson
Peter
P
Ittak
Terry
T
Dwyer
Leigh
L
Blizzard
Kerry R
KR
Delaney
Keith W A
KW
Horsley
Warren K
WK
Harrex
Harry
H
Schwarz
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*