Chronic Multisymptom Illness: A Comparison of Iraq and Afghanistan Deployers With Veterans of the 1991 Gulf War

• Published in: American journal of epidemiology Vol. 180; no. 12; pp. 1176 - 1187
• Main Authors: SMITH, Tyler C, POWELL, Teresa M, JACOBSON, Isabel G, SMITH, Besa, HOOPER, Tomoko I, BOYKO, Edward J, GACKSTETTER, Gary D
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.12.2014; Oxford Publishing Limited (England)
• Subjects: Adult; Afghanistan; Age Factors; Biological and medical sciences; Chronic Disease - epidemiology; Chronic Disease - psychology; Chronic illnesses; Clinical psychology; Epidemiology; Fatigue - epidemiology; Female; General aspects; Gulf War; Health Behavior; Humans; Iraq; Male; Medical sciences; Medical screening; Mental Disorders - epidemiology; Middle Aged; Military deployment; Miscellaneous; Musculoskeletal Pain - epidemiology; Occupations - statistics & numerical data; Persian Gulf War; Prevalence; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex Factors; Socioeconomic Factors; Time Factors; United States; Veterans; Veterans - psychology; Veterans - statistics & numerical data; War; Afghanistan; Iraq; Asia; United States; North America; America; United States > US; Self evaluation; Chronic disease; Epidemiology; illnesses in Gulf War Veterans; multisystem illness; Symptomatology; Chronic; 1991; Gulf war syndrome; Veteran; Comparative study; Public health; symptom self-reporting; Gulf War syndrome
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwu240

Symptoms and illnesses reported by veterans of the 1991 Gulf War era are a cause of potential concern for those military members who have deployed to the Gulf region in support of more recent contingency operations in Iraq and Afghanistan. In the present study, we quantified self-reported symptoms from participants in the Millennium Cohort Study, a prospective study representing all US service branches, including both active duty and Reserve/National Guard components (2001-2008). Self-reported symptoms were uniquely compared with those in a cohort of subjects from the 1991 Gulf War to gain context for the present report. Symptoms were then aggregated to identify cases of chronic multisymptom illness (CMI) based on the case definition from the Centers for Disease Control and Prevention. The prevalence of self-reported CMI symptoms was compared with that collected in 1997-1999 from a study population of US Seabees from the 1991 Gulf War, as well as from deployed and nondeployed subgroups. Although overall symptom reporting was much less in the Millennium Cohort than in the 1991 Gulf War cohort, a higher prevalence of reported CMI was noted among deployed compared with nondeployed contemporary cohort members. An increased understanding of coping skills and resilience and development of well-designed screening instruments, along with appropriate clinical and psychological follow-up for returning veterans, might help to focus resources on early identification of potential long-term chronic disease manifestations.