A new study from the USA has found that deployment in the Gulf
War was associated with increased levels of mental disorders,
psychological symptoms, and a lower quality of life - beginning
during the war and persisting at a lower rate 10 years later.
Around 700,000 US military personnel were deployed to the Middle
East during the 1991 Persian Gulf War. These veterans reported
greater psychological symptoms immediately after the war than
veterans who were not sent to the Gulf.
The National Health Survey of Gulf War Era Veterans and Their
Families was a study designed to collect information at several
time points to assess the prevalence of medical and psychological
conditions in both deployed and non-deployed veterans.
Postal and telephone surveys were conducted among 15,000
deployed veterans and 15,000 non-deployed veterans, beginning in
1995.
The current study, published in the May issue of the British
Journal of Psychiatry, evaluated a sub-set of these veterans, using
face-to-face psychological examinations conducted between 1998 and
2001. Mental disorders were diagnosed using structural clinical
interviews, and standard questionnaires assessed psychological
symptoms and quality of life.
Both the deployed and the non-deployed veteran groups were 78%
male. The deployed group were nearly 2 years younger than the
non-deployed group, were more likely to be African-American, had
lower levels of education and were less likely to be married or
officers.
It was found that the prevalence of onset of mental disorders at
the time of the war was significantly higher among deployed
compared with non-deployed veterans.
In particular, deployed veterans had an increased incidence of
depression, post-traumatic stress disorder (PTSD) and non-PTSD
anxiety disorders.
10 years later, these cases of depression and non-PTSD anxiety
disorders remained significantly more prevalent among deployed
compared with non-deployed veterans. PTSD was over 3 times more
prevalent among deployed veterans.
Depression was less likely to improve among deployed than
non-deployed veterans, although the levels of antidepressant use,
and the severity of depression in the 2 groups were similar.
Depressed deployed veterans were nearly twice as likely as
depressed non-deployed veterans to have additional mental disorders
at the time of the war, which could explain the reduced likelihood
that depression would improve in the deployed veterans group. Lower
levels of education in the deployed group may also have contributed
to their continued depression compared with the non-deployed
group.
The authors of the study comment that the findings indicate that
deployment had a range of adverse effects on both health-related
and non-health-related quality of life 10 years later.
The results also suggest that pre-existing mental disorders
represent an individual vulnerability factor for the development of
mental disorders during war deployment.
Although continued depression in deployed veterans appeared
partially resistant to improvement despite comparable levels of
medication in the 2 groups, the authors conclude that anxiety
disorders might possibly improve further with greater use of
medication.
Overall, the findings point to the need for adequate follow-up
mental healthcare for veterans with persistent mental illnesses
following major military deployments.