title: Mental health status following severe sulfur mustard exposure: a long-term study of Iranian war survivors.
abstract: BACKGROUND
  This study aimed to describe the mental health status of sulfur mustard-exposed survivors suffering from severe respiratory and ophthalmological problems.
  
  
  METHODS
  Out of 450 invited Iran-Iraq War survivors of sulfur mustard exposure with severe symptoms, 350 participated in this cross-sectional study. Mental health status was assessed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria. Fisher exact test, Pearson chi-square test, and chi-square test were used to assess any relationship, and the independent-sample t test was employed to compare differences between the veterans with ocular and pulmonary injuries.
  
  
  RESULTS
  There were 60.9% (n = 213) survivors who suffered from mental disorders. Among them, 39.7% (n = 139) were previously untreated and required the initiation of psychiatric treatment. The prevalence of anxiety and mood disorders among all survivors was 40.6% (n = 142) and 32.0% (n = 112), respectively. The most common anxiety and mood disorders were posttraumatic stress disorder (32.9%, n = 115) and major depressive disorder (22.3%, n = 78), respectively. Psychiatric disorders were more prevalent in cases with severe pulmonary chemical injury than in subjects with severe ophthalmologic chemical injury. Significant relationships were found between the types of psychiatric disorders and age, education, and occupation (P < .05).
  
  
  CONCLUSIONS
  The psychiatric morbidity in the chemically injured populations was remarkable and significantly different between the populations. The prevalence of mental illness in these groups highlights the need for the appropriate provision of mental health services.
authors: Medical Toxicologist, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors: Shahriar
authors: S
authors: Khateri
authors: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors: Mohammadreza
authors: M
authors: Soroush
authors: Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Naghmeh
authors: N
authors: Mokhber
authors: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors: Mohammadreza
authors: M
authors: Sedighimoghaddam
authors: Emergency Medicine, Boali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
authors: Ehsan
authors: E
authors: Modirian
authors: Community and Preventive Medicine, Prevention Department, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors: Batool
authors: B
authors: Mousavi
authors: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors: Seyed Javad
authors: SJ
authors: Mousavi
authors: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran.
authors: Maryam
authors: M
authors: Hosseini
mesh_terms: D000328:Adult; D000368:Aged; D002619:Chemical Warfare Agents / Q000506:poisoning*; D003430:Cross-Sectional Studies; D005739:Gas Poisoning / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced / Q000453:epidemiology*; D008875:Middle Aged; D009151:Mustard Gas / Q000506:poisoning*; D015995:Prevalence; D017741:Survivors
chemical_list: D002619:Chemical Warfare Agents; D009151:Mustard Gas
keywords: Iran-Iraq War; PTSD; chemical weapons; psychiatric disorders; sulfur mustard