Chronic Widespread Pain 5 years Following the Gulf War: A Population Based Study

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Chronic Widespread Pain 5 years Following the Gulf War: A Population Based

Study

Category:  11 Soft tissue and regional musculoskeletal disease,

fibromyalgia

M Peloso, Brad N Doebbeling, Bodgan Cherascu, Elena Letuchy, Tomi

Sampson

University of Iowa Health Care, Iowa City, IA

Presentation Number: 188

Poster Board Number: 188

Keywords: chronic pain, Gulf War, prevalence

The Gulf War (08-90 to 06-91) was one of the largest single deployment of

troops in history. Upon return, a variety of symptoms began to be reported.

We wished to understand the prevalence of and contributors to chronic

widespread pain (CWP) in those deployed to the Gulf compared to a control

group eligible, but not deployed.

Methods: Using DoD records, individuals listing Iowa as the home of record

were telephone interviewed 5 years after the conflict about their general

health status, using a broad array of of measures. A stratified random

sample was drawn from 4 domains based on deployment and military status. CWP

was defined as pain present in the last year and the last one month,

moderate or greater in severity and involvement of upper and lower

extremities and trunk. SUDAAN and SAS were used to used to calculate

prevalence rates as percentages (SE). Logistic regression was used to assess

relationship of CWP (Yes/No) to other health variables.

Results: 3,695 of 4,886 eligible subjects were interviewed. 19.2%(0.96) of

those deployed reported CWP versus 9.6%(0.85) of the non-deployed. Bivariate

relationships existed for several domains of health and these included

Military factors: reservist status vs. enlisted, and enlisted vs. officers,

army vs. other branches, those who saw combat versus not, least prepared for

battle; Social factors: less than high school education, single, current

smoking; Mental health factors: having seen a mental health professional

prior to deployment, prior depression; Medical factors: prior back pain or

rheumatism, recurrent migraines, asthma, gastritis, and prior bowel

disturbance (diarrhea, colitis) were all related to complaints of CWP. Final

multivariable models showed reservists (OR 1.6,1.3-1.9) enlisted soldiers

(OR 2.1 1.3-4.2), to be more likely to have CWP. Current smokers were more

likely (OR 1.4 1.0-1.8), as were those deployed to the Gulf (OR 1.9,

1.4-2.4) and those who saw combat (OR 3.4, 2.6- 4.5). Those who saw a mental

health professional prior to the Gulf War (OR 1.6, 1.2-2.2) those with

asthma (3.0, 1.1-8,6) and those with high scores on a somatic distress scale

(OR 1.6, 1.4-1.7) and psychological distress (OR 1.2, 1.0-3.8) also were at

risk for higher reporting of CWP; c-statistic 0.745, Hosmer-Lemeshow

Goodness of fit, p = 0.03.

Conclusion: There were high rates of CWP reporting following the Gulf War,

with deployment increasing the risk of reporting. Military, personal, and

mental health factors were all important in reporting CWP.