Gulf War syndrome not due to a mental disorder

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Gulf War syndrome not due to a mental disorder

Last Updated: 2002-09-13 10:01:01 -0400 (Reuters Health)

By Charnicia E. Huggins

NEW YORK (Reuters Health) - The fatigue, irritability and various other

symptoms reported by some Gulf War veterans do not seem to be caused by any

psychiatric disorder, new study findings show.

In fact, Gulf War veterans do not seem to have a higher rate of

post-traumatic stress disorder (PTSD) or any other psychiatric illnesses

than non-Gulf War veterans, UK researchers report.

" Whatever is the nature of ill health in Gulf veterans, it can't be

explained by mental illness, " Dr. Khalida Ismail of Guy's, King's and St.

's School of Medicine in London told Reuters Health.

" But we are still left with 'why are Gulf veterans reporting ill health more

often than non-Gulf veterans,' " Ismail said.

Some Gulf War veterans report a variety of symptoms, from tiredness,

convulsions and respiratory and digestive problems to nerve damage, pain,

numbness and psychological difficulties.

The causes of the symptoms--commonly referred to as Gulf War syndrome--have

been hotly debated and linked variously to the inoculations the veterans

received, pesticide exposure, smoke from burning fires and stress. Some

experts, however, believe that the syndrome is not due to a physical cause

but rather a psychological one.

To investigate the possible association between psychiatric disorders and

the ill health reports, the researchers studied 111 UK Gulf War veterans

with an unexplained physical disability and 98 non-disabled UK Gulf War

veterans. The investigators compared their mental health status with that of

other military personnel who either served in the 1992-1997 Bosnia

peacekeeping mission or who were not deployed during the 1990-1991 Persian

Gulf conflict.

Overall, disabled Gulf veterans were more likely to suffer from a

psychiatric disorder than non-disabled veterans, the authors report in the

September 14th issue of the British Medical Journal.

Still, only about one in four disabled Gulf War veterans had some type of

depression, anxiety, alcohol-related or other formal psychiatric disorder,

and this rate was similar to that found among disabled non-Gulf War

veterans, study findings indicate.

The one exception was for somatoform disorders--characterized by unexplained

physical symptoms that are either initiated or aggravated by psychological

stress--which were three times more common among disabled Gulf War vets, the

researchers note.

Finally, all of the study groups had similarly low rates of post-traumatic

stress disorder, which affected from 1% to 3% of the disabled and

non-disabled Gulf War veterans, and the non-Gulf War veterans, respectively.

In light of the findings, " psychiatric disorders do not fully explain

self-reported ill health in Gulf veterans; alternative explanations...are

needed, " the researchers conclude.

Some possible reasons for the ill health reports may be due to the " high

expectations of physical health in military personnel, " or because

" conventional concepts of what is psychologically traumatic may not apply to

modern combat, " according to Ismail.

" For instance, while there were relatively few Allied casualties during the

Gulf conflicts, the veterans experienced real risks from biological and

chemical weapons, " Ismail said. " How these risks were communicated and

experienced by the veterans is poorly understood. "

Further, " more research is needed on the veterans' mental health status

before the Gulf conflict, as well as on the social mechanisms, such as the

role of the media, " Ismail said.

SOURCE: British Medical Journal 2002;325:576-591.