Skip to main content Accessibility help
×
Home

Psychiatric disorder in veterans of the Persian Gulf War of 1991: Systematic review

  • Nicola J. Stimpson (a1), Hollie V. Thomas (a1), Alison L. Weightman (a1), Frank Dunstan (a1) and Glyn Lewis (a2)...

Abstract

Background

Veterans of the Persian Gulf War of 1991 have reported symptoms attributed to their military service.

Aims

To review all studies comparing the prevalence of psychiatric disorders in Gulf War veterans and in a comparison group of service personnel not deployed to the Gulf War.

Method

Studies of military personnel deployed to the Gulf published between 1990 and 2001 were identified from electronic databases. Reference lists and websites were searched and key researchers were contacted for information. Atotal of 2296 abstracts and 409 complete articles were reviewed and data were extracted independently by two members of the research team.

Results

The prevalence of psychiatric disorder in 20 studies of Gulf War veterans was compared with the prevalence in the comparison group. Prevalence of post-traumatic stress disorder (PTSD) and common mental disorder were higher in the Gulf War veterans. Heterogeneity between studies was significant, but all reported this increased prevalence.

Conclusions

Veterans of the Persian Gulf War reported an increased prevalence of PTSD and common mental disorder compared with other active service personnel not deployed to the Gulf. These findings are attributable to the increase in psychologically traumatic events in wartime.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Psychiatric disorder in veterans of the Persian Gulf War of 1991
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Psychiatric disorder in veterans of the Persian Gulf War of 1991
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Psychiatric disorder in veterans of the Persian Gulf War of 1991
      Available formats
      ×

Copyright

Corresponding author

Professor Glyn Lewis, Cotham House, Cotham Hill, Bristol BS6 6JL, UK. E-mail: glyn.lewis@bristol.ac.uk

Footnotes

Hide All

Declaration of interest

Funded by the UK Medical Research Council.

Footnotes

References

Hide All
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.
Bartone, P. T. (2000) Hardiness as a resiliency factor for United States forces in the Gulf War. In Posttraumatic Stress Intervention: Challenges, Issues and Perspectives (ed. Paton, D.), pp. 115133. Springfield, IL: Charles C. Thomas.
Beck, A. T., Ward, C. H., Mendelsohn, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.
Blake, D., Weathers, F., Nagy, L., et al (1990) Clinician Administered PTSD Scale. Boston, MA: National Center for PTSD, Behavioral Sciences Division.
Bradburn, M. J., Deekes, J. J. & Altman, D. G. (1998) METAN – an alternative meta-analysis command. Stata Technical Bulletin, 44, 415.
Cherry, N., Creed, F., Silman, A., et al (2001) Health and exposures of United Kingdom Gulf war veterans. Part l: The pattern and extent of ill health. Occupational and Environmental Medicine, 58, 291298.
Derogatis, L. R. (1977) The SCL–90–R Manual I: Scoring, Administration and Procedures for the SCL–90. Baltimore, MD: Johns Hopkins University School of Medicine.
Derogatis, L. R. & Melisaratos, N. (1983) The Brief Symptom Inventory: an introductory report. Psychological Medicine, 13, 595605.
Derogatis, L. R. & Spencer, P. M. (1982) The Brief Symptom Inventory: Administration, Scoring and Procedures Manual. Baltimore, MD: Johns Hopkins University School of Medicine, Clinical Psychometrics Research Unit.
Derogatis, L. R., Lipman, R. S., Rickels, K., et al (1974) The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behavioural Science, 19, 115.
Ewing, J. A. (1984) Detecting alcoholism: the CAGE questionnaire. JAMA, 252, 19051907.
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders: A Biopsychosocial Approach. London: Routledge.
Goldberg, D. & Williams, P. (1988) The User's Guide to the General Health Questionnaire. Windsor: NFER–Nelson.
Goss Gilroy Inc. (1998) Health Study of Canadian Forces Personnel Involved in the 1991 Conflict in the Persian Gulf (vol. 1). Ottawa: Goss Gilroy Inc. http://www.dnd.ca/menu/press/Reports/Health/health_study_e_voll_TOC.htm
Gray, G. C., Kaiser, K. S., Hawksworth, A. W., et al (1999) Increased postwar symptoms and psychological morbidity among US Navy Gulf War veterans. American Journal of Tropical Medicine and Hygiene, 60, 758766.
Holmes, D. T., Tariot, P. N. & Cox, C. (1998) Preliminary evidence of psychological distress among reservists in the Persian Gulf War. Journal of Nervous and Mental Disease, 186, 166173.
Horowitz, M., Wilner, N. & Alvarex, W. (1979) Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209218.
Iowa Persian Gulf Study Group (1997) Self-reported illness and health status among Gulf War veterans. A population-based study. JAMA, 277, 238245.
Ishoy, T., Suadicani, P., Guldager, B., et al (1999) State of health after deployment in the Persian Gulf – the Danish Gulf War Study. Danish Medical Bulletin, 46, 416419.
Jenkins, R., Lewis, G., Bebbington, P., et al (1997) The National Psychiatric Morbidity Surveys of Great Britain: initial findings from the Household Survey. Psychological Medicine, 27, 775790.
Kang, H. K., Mahan, C. M., Lee, K. Y., et al (2000) Illnesses among United States veterans of the Gulf War: a population-based survey of 30, 000 veterans. Journal of Occupational and Environmental Medicine, 42, 491501.
Keane, T. M., Caddell, J. M. & Taylor, K. L. (1988) Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 8590.
Kessler, R. C., McGonagle, K. A., Zhao, S., et al (1994) Lifetime and 12-month prevalence of DSM–III–R psychiatric disorders in the United States. Archives of General Psychiatry, 51, 819.
Lewis, G., Churchill, R. & Hotopf, M. (1997) Systematic reviews and meta-analysis. Psychological Medicine, 27, 37.
Perconte, S. T., Wilson, A. T., Pontius, E. B., et al (1993) Psychological and war stress symptoms among deployed and non-deployed reservists following the Persian Gulf War. Military Medicine, 158, 516521.
Pierce, P. F. (1997) Physical and emotional health of Gulf War veteran women. Aviation, Space and Environmental Medicine, 68, 317321.
Proctor, S. P., White, R. F., Wolfe, J., et al (1998) Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress. International Journal of Epidemiology, 27, 10001010.
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. E. (1970) STAI: Manual for the State–Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Spitzer, R. L., Williams, J. B. W., Gibbon, M., et al (1990) User's Guide for the Structured Clinical Interview for DSM–III–R: SCID.Washington, DC: American Psychiatric Association.
Spitzer, R. L., Williams, J. B. W., Kroenke, K., et al (1994) Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME–MD 1000 study. JAMA, 272, 17491756.
StataCorp (1999) Stata Statistical Software. College Station, TX: Stata Corporation.
Steele, L. (2000) Prevalence and patterns of Gulf War illness in Kansas veterans: association of symptoms with characteristics of person, place and time of military service. American Journal of Epidemiology, 152, 9921002.
Stretch, R. H., Bliese, P. D., Marlowe, D. H., et al (1996a) Psychological health of Gulf War-era military personnel. Military Medicine, 161, 257261.
Stretch, R. H., Marlowe, D. H., Wright, K. M., et al (1996b) Post-traumatic stress disorder symptoms among Gulf War veterans. Military Medicine, 161, 407410.
Stuart, J. A. & Bliese, P. D. (1998) The long-term effects of operation desert storm on the psychological distress of US army reserve and national guard veterans. Journal of Applied Social Psychology, 28, 122.
Stuart, J. A. & Halverson, R. R. (1997) The psychological status of US Army soldiers during recent military operations. Military Medicine, 162, 737743.
Sutker, P. B., Uddo, M., Brailey, K., et al (1993) War-zone trauma and stress-related symptoms in Operation Desert Shield/Storm (ODS) returnees. Journal of Social Issues, 49, 3350.
Sutker, P. B., Uddo, M., Brailey, K., et al (1994) Psychopathology in war-zone deployed and non-deployed operation desert storm troops assigned registration duties. Journal of Abnormal Psychology, 103, 383390.
Unwin, C., Blatchley, N., Coker, W., et al (1999) Health of UK servicemen who served in Persian Gulf War. Lancet, 353, 169178.
Weathers, F., Litz, B. T., Heran, D. S., et al (1993) The PTSD Checklist (PCL): Reliability, Validity, and Diagnostic Utility. San Antonio, TX: International Society of Traumatic Stress Studies.
Williams, P. & Macdonald, A. (1986) The effect of non-response bias on the results of two-stage screening surveys of psychiatric disorder. Social Psychiatry, 21, 182186.
Wolfe, J., Proctor, S. P., Erickson, D.J., et al (1999) Relationship of psychiatric status to Gulf War veterans' health problems. Psychosomatic Medicine, 61, 532540.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Psychiatric disorder in veterans of the Persian Gulf War of 1991: Systematic review

  • Nicola J. Stimpson (a1), Hollie V. Thomas (a1), Alison L. Weightman (a1), Frank Dunstan (a1) and Glyn Lewis (a2)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *