title: Depression in Gulf War veterans: a systematic review and meta-analysis.
abstract: BACKGROUND
  Although post-traumatic stress disorder (PTSD) has been a focus of attention in 1990/1991 Gulf War veterans, the excess risk of depression has not been clearly identified. We investigated this through a systematic review and meta-analysis of studies comparing depression in Gulf War veterans to depression in a comparison group of non-deployed military personnel.
  
  
  METHODS
  Multiple electronic databases and grey literature were searched from 1990 to 2012. Studies were assessed for eligibility and risk of bias according to established criteria.
  
  
  RESULTS
  Of 14 098 titles and abstracts assessed, 14 studies met the inclusion criteria. Gulf War veterans had over twice the odds of experiencing depression [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.88-2.76] and dysthymia or chronic dysphoria (OR 2.39, 95% CI 2.0-2.86) compared to non-deployed military personnel. This finding was robust in sensitivity analyses, and to differences in overall risk of bias and psychological measures used.
  
  
  CONCLUSIONS
  Despite divergent methodologies between studies, depression and dysthymia were twice as common in Gulf War veterans and are important medical conditions for clinicians and policymakers to be aware of in managing Gulf War veterans' health.
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences,Monash Centre for Occupational and Environmental Health (MonCOEH),School of Public Health and Preventive Medicine,Monash University,L5,The Alfred Centre,Melbourne,VIC,Australia.
authors.forename: J D
authors.initials: JD
authors.lastname: Blore
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences,Monash Centre for Occupational and Environmental Health (MonCOEH),School of Public Health and Preventive Medicine,Monash University,L5,The Alfred Centre,Melbourne,VIC,Australia.
authors.forename: M R
authors.initials: MR
authors.lastname: Sim
authors.affiliation: Faculty of Medicine,Nursing and Health Sciences,School of Public Health and Preventive Medicine,Monash University,L6,The Alfred Centre,VIC,Australia.
authors.forename: A B
authors.initials: AB
authors.lastname: Forbes
authors.affiliation: Department of Psychiatry,Australian Centre for Posttraumatic Mental Health,The University of Melbourne,Parkville,VIC,Australia.
authors.forename: M C
authors.initials: MC
authors.lastname: Creamer
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences,Monash Centre for Occupational and Environmental Health (MonCOEH),School of Public Health and Preventive Medicine,Monash University,L5,The Alfred Centre,Melbourne,VIC,Australia.
authors.forename: H L
authors.initials: HL
authors.lastname: Kelsall
mesh_terms: D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D047830:Gulf War; D006801:Humans; D016017:Odds Ratio; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: veterans