title: Chronic multisymptom illness among female Veterans deployed to Iraq and Afghanistan.
abstract: BACKGROUND
  Chronic multisymptom illness (CMI) may be more prevalent among female Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) deployed Veterans due to deployment-related experiences.
  
  
  OBJECTIVE
  To investigate CMI-related diagnoses among female OEF/OIF/OND Veterans.
  
  
  METHODS
  We estimated the prevalence of the International Classification of Disease-9th edition-Clinical Modification coded CMI-related diagnoses of chronic fatigue syndrome, fibromyalgia (FM), and irritable bowel syndrome (IBS) among female OEF/OIF/OND Veterans with Veterans Health Administration (VHA) visits, FY2002-2012 (n=78,435). We described the characteristics of female Veterans with and without CMI-related diagnoses and VHA settings of first CMI-related diagnoses.
  
  
  RESULTS
  The prevalence of CMI-related diagnoses among female OEF/OIF/OND Veterans was 6397 (8.2%), over twice as high as the prevalence 95,424 (3.9%) among the totality of female Veterans currently accessing VHA (P<0.01). There were statistically significant differences in age, education, marital status, military component, service branch, and proportions of those with depression and/or post-traumatic stress disorder diagnoses across females with and without CMI-related diagnoses. Diagnoses were mainly from primary care, women's health, and physical medicine and rehabilitation clinics.
  
  
  CONCLUSIONS
  CMI-related diagnoses were more prevalent among female OEF/OIF/OND Veterans compared with all female Veterans who currently access VHA. Future studies of the role of mental health diagnoses as confounders or mediators of the association of OEF/OIF/OND deployment and CMI are warranted. These and other factors associated with CMI may provide a basis for enhanced screening to facilitate recognition of these conditions. Further work should evaluate models of care and healthcare utilization related to CMI in female Veterans.
authors.affiliation: *Informatics, Decision Enhancement, and Surveillance (IDEAS) Center, VA Salt Lake City Health Care System, Department of Internal Medicine, University of Utah School of Medicine †Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT ‡Department of Veteran Affairs, War Related Illness and Injury Study Center, New Jersey Health Care System, East Orange, NJ §Department of Education and Counseling Psychology, University of Albany, Albany, NY.
authors.forename: April F
authors.initials: AF
authors.lastname: Mohanty
authors.forename: Anusha
authors.initials: A
authors.lastname: Muthukutty
authors.forename: Marjorie E
authors.initials: ME
authors.lastname: Carter
authors.forename: Miland N
authors.initials: MN
authors.lastname: Palmer
authors.forename: Joshua
authors.initials: J
authors.lastname: Judd
authors.forename: Drew
authors.initials: D
authors.lastname: Helmer
authors.forename: Lisa M
authors.initials: LM
authors.lastname: McAndrew
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Garvin
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Samore
authors.forename: Adi V
authors.initials: AV
authors.lastname: Gundlapalli
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D002908:Chronic Disease; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology*; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology*; D006801:Humans; D054542:Iraq War, 2003-2011; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans