title: Mental health comorbidity patterns and impact on quality of life among veterans serving during the first Gulf War.
abstract: OBJECTIVE
  To examine the patterns of coexisting (comorbid) mental disorders and whether comorbidity influences quality of life ratings in a sample of U.S. veterans.
  
  
  METHODS
  The Iowa Gulf War Study Case Validation study evaluated 602 military personnel, two-thirds of whom had symptoms of depression, cognitive dysfunction, or chronic widespread pain, who were activated or on active duty sometime during the first Gulf War (GW). Mental health disorders were defined using the SCID-IV, and the Health Utilities Index Mark 3 (HUI3) was used to measure health-related quality of life (HRQoL). Comorbidity was defined as having two or more mental disorders that spanned across at least two separate categories (e.g., depressive disorders and anxiety disorders).
  
  
  RESULTS
  Over 35% of veterans with a current mental disorder had at least one other comorbid mental disorder. Those with mental disorder comorbidity had lower HUI scores than veterans with only one or less mental disorders (mean 0.41 +/- 0.30 vs. 0.72 +/- 0.25, p < 0.0001).
  
  
  CONCLUSIONS
  The co-occurrence of mental disorders that span at least two mental disorder categories is associated with impaired HRQoL in this veteran population. Early identification of mental health comorbidity may lead to interventions to enhance HRQoL among military personnel.
authors.affiliation: Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, 52242, USA. valerie-hoffman@uiowa.edu
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Forman-Hoffman
authors.forename: Caroline P
authors.initials: CP
authors.lastname: Carney
authors.forename: Tomoko R
authors.initials: TR
authors.lastname: Sampson
authors.forename: Paul M
authors.initials: PM
authors.lastname: Peloso
authors.forename: Robert F
authors.initials: RF
authors.lastname: Woolson
authors.forename: Donald W
authors.initials: DW
authors.lastname: Black
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D000328:Adult; D015897:Comorbidity / Q000639:trends*; D005260:Female; D047830:Gulf War; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011788:Quality of Life; D014728:Veterans / Q000523:psychology*