War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War.
Ikin JF., Sim MR., Creamer MC., Forbes AB., McKenzie DP., Kelsall HL., Glass DC., McFarlane AC., Abramson MJ., Ittak P., Dwyer T., Blizzard L., Delaney KR., Horsley KWA., Harrex WK., Schwarz H.
BACKGROUND: Questions remain about the long-term health impacts of the 1991 Gulf War on its veterans. AIMS: To measure psychological disorders in Australian Gulf War veterans and a military comparison group and to explore any association with exposure to Gulf War-related psychological stressors. METHOD: Prevalences of DSM-IV psychological disorders were measured using the Composite International Diagnostic Interview. Gulf War-related psychological stressors were measured using a service experience questionnaire. RESULTS: A total of 31% of male Gulf War veterans and 21% of the comparison group met criteria for a DSM-IV disorder first present in the post-Gulf War period. The veterans were at greater risk of developing post-Gulf War anxiety disorders including post-traumatic stress disorder, affective disorders and substance use disorders. The prevalence of such disorders remained elevated a decade after deployment. The findings can be explained partly as a 'war-deployment effect'. There was a strong dose-response relationship between psychological disorders and number of reported Gulf War-related psychological stressors. CONCLUSIONS: Service in the 1991 Gulf War is associated with increased risk of psychological disorders and these are related to stressful experiences.